This research paper will concentrate on the transmission of the human immunodeficiency virus from mother to child, the benefits of drugs intervention, and whether or not the HIV-screening process of pregnant women should remain voluntary or become mandatory. The HIV-virus has proven that it is not a disease to be taken lightly or ignored. I chose this topic because I want to be informed about the virus and its rate of vertical transmission so that I will be able to inform others about such ethical topics: Does the baby have rights and should a pregnant women be denied her right to privacy with respect to HIV?Data shows that AIDS is now increasing faster among females than males, with women accounting for seven percent of cases in 1985 and nineteen percent in 1995. The incidences of HIV-positive heterosexual women have risen dramatically over the past decade, and AIDS is now the third leading cause of death among women ages twenty-five to forty-four.
The one thing that all of these women have in common is that they all are of child bearing age. Consequently, the incidences of HIV-positive newborns have alsoincreased. As mentioned previously, about seven thousand HIV-infected women give birth each year, and about twenty-five percent of their babies are HIV-positive. Maternal transmission accounted for ninety-two percent of all new AIDS cases reported in children in 1994(Davis15). A major breakthrough in drug intervention began in February 1993.
The AIDS Clinical Trials Group administered a double-blinded, randomized, placebo-controlled study of zidovudine, also known as AST. Four hundred seventy-five women were enrolled in the study. These women were randomly assigned to one of two groups. One group received zidovudine while the other, the control group, received a placebo. The administration of either zidovudine or placebo began in the second trimester of pregnancy and continued through labor. For six weeks after birth, the babies received the same treatment as the mothers in a syrup form.
Because it was a double-blinded study, neither the researchers nor the patients knew who was actually receiving the zidovudine. Only three hundred sixty-four babies of the four hundred twenty-one born were available for testing. Results showed that, of the three hundred sixty-four available for testing, fifty-three were infected with HIV; thirteen were born to mothers receiving zidovudine and forty to mothers on placebo (FDA Consumer 3). According to this data, when both mothers and babies received zidovudine, there was a transmission rate of 8. 3 percent.
This was a dramatic decrease in the rate of transmission when compared to the control group who had a transmission rate of 25. 5 percent. With results such as these, drug intervention with respect to both pregnant women and newborns should become more commonplace with each day. For example, if the decrease in maternal transmission rate is duplicated from the AIDS Clinical Trials Group study, and the estimated seven thousand HIV-infected women deliver infants while accepting treatment with zidovudine, one will conclude that under these hypothetical conditions, as many as two-thirds, or twelve hundred, of all vertically acquired HIV-infections could be prevented annually(Davis 15).
This decrease in maternal transmission would be ideal if all conditions were met, but there seems to be one major flaw. Many pregnant women do not know they are infected with HIV. The problem now is how to identify HIV-infected pregnant women at an early enough stage, so that the use of AZT could drastically reduce the chances of the baby being born with HIV. It is critical that the physician know of a womens HIV-infection prior to or early in her pregnancy. Because many women who are at risk are completely unaware of it, a growing national debate has centered on mandatory HIV testing of all pregnant women.
This notion of mandatory screening has raised many ethical issues. It is certain that those who test positive and accept treatment with AZT would have a decreased transmission rate,