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Panel urges all pregnant women to get HIV test

A federal panel is recommending that all pregnant women, not just those considered at high risk, be screened for the AIDS virus because testing has proven so successful at helping prevent the spread of the disease to babies.

The U.S. Preventive Services Task Force said in 1996 that there was insufficient evidence that screening all pregnant women had any benefit. But the independent panel of medical experts said in today's Annals of Internal Medicine that scientific advances have changed that.

"We're hoping that this will encourage women to think of HIV testing during pregnancy the way they think of all other testing during pregnancy," said Dr. Diana Petitti, the task force's vice chair.

HIV-infected pregnant women can be given combination drug therapies, have Caesarean sections or avoid breast-feeding to help keep their babies safe - reducing the risk to as low as 1 percent, the task force said.

Otherwise, infected women have a 1-in-4 chance of passing AIDS to their babies. Of the 4.7-million women hospitalized for pregnancy or childbirth in 2002, nearly 6,300 had HIV.

The recommendation follows a 2001 directive by the federal Centers for Disease Control and Prevention, which emphasized HIV testing "as a routine part of prenatal care and strengthened the recommendation that all pregnant women be tested for HIV," said CDC spokeswoman Jessica Frickey.

Sharon Hillier, a professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine, said there are many women who don't know they have the virus.

"It's astonishing how people still don't understand that this can happen to almost anybody. Women don't always know if their partners have had other sex partners," Hillier said.

About 40,000 Americans are infected with HIV each year, and about 27 percent of those are women. Many pregnant women are already offered the tests but refuse.

CHICAGO - A respected medical panel is urging pediatricians not to focus only on height and weight in determining whether a child is too fat.

Leading groups of family doctors and pediatricians endorse routine screening using the height-weight ratio of the body-mass index. But there's no evidence that all children with high BMIs need to lose weight to be healthy - and there's no evidence that pediatricians' weight counseling results in weight loss, according to the U.S. Preventive Services Task Force, a nongovernmental panel of researchers.

BMI can be fairly effective at identifying children who likely have weight problems, said Dr. Virginia Moyer, a task force member. But it can't determine if body mass is mostly fat or lean tissue, and not all children with high BMIs need to lose weight, said Moyer, a pediatrics professor at the University of Texas Health Science Center in Houston.

Moyer and other task force members said in July's Pediatrics, published today, that more conclusive research is needed into what works to identify and treat overweight children in a doctor's-office setting.

CHICAGO - A leading group of pediatricians says teenagers need access to birth control and emergency contraception, not the abstinence-only approach to sex education favored by religious groups and President Bush.

The recommendations are part of the American Academy of Pediatrics' updated teen pregnancy policy.

"Even though there is great enthusiasm in some circles for abstinence-only interventions, the evidence does not support abstinence-only interventions as the best way to keep young people from unintended pregnancy," said Dr. Jonathan Klein, chairman of the academy committee that wrote the new recommendations.

Teaching abstinence but not birth control makes it more likely that once teenagers initiate sexual activity they will have unsafe sex and contract sexually transmitted diseases, said Dr. S. Paige Hertweck, a pediatric obstetrician-gynecologist at the University of Louisville who provided advice for the report.

The report appears in July's Pediatrics, published today.

It updates a 1998 policy by omitting the statement that "abstinence counseling is an important role for all pediatricians." The new policy says that while doctors should encourage adolescents to postpone sexual activity, they also should help ensure that all teens have access to birth control.

[Last modified July 5, 2005, 01:34:07]