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McCormick Heads IOM Panel That
Recommends Routine Prenatal HIV Testing
Each year, thousands of babies in the US are born infected with
human immunodeficiency virus (HIV). Many of these babies could be
born infection-free if prenatal HIV testing became routine, according to an
Institute of Medicine (IOM) report issued by a panel chaired by
Marie McCormick, Sumner and Esther Feldberg Professor of Maternal
and Child Health and Director of the Harvard Center for
Children's Health.
In 1994, a therapy was discovered that reduced by two-thirds the chance that an infected pregnant woman would pass HIV to her child. This led to the creation of federal guidelines that advised caregivers to encourage expectant mothers to be tested for HIV, with the caveat that they offer extensive pre-test counseling about the risks of AIDS and the benefits of being tested. As a result, testing and treatment increased and the number of new pediatric AIDS cases declined by about 43 percent between 1992 and 1996.
However, according to the panel, many barriers prevent or inhibit caregivers from counseling and testing every expectant mother. Some physicians have complained that the counseling can take up to fifteen minutes of an appointment at which this is only one of many important topics of discussion. The guidelines also place the burden on physicians to decide whether some women are at higher risk than others and should therefore be more vigorously encouraged to be tested for HIV.
"By making HIV screening a routine part of prenatal care for all pregnant women, regardless of their risk factors, we can further lower the number of pediatric AIDS cases and help infected women get high-quality treatment," said McCormick. The committee advises that the HIV test should be included in the battery of tests that all women routinely undergo in the early stages of pregnancy. Women would be told that they will be tested and given the option to refuse, but caregivers should be freed from the responsibility of having to convince women of the test's importance.
The report, Reducing the Odds: Preventing Perinatal Transmission of HIV in the United States, has been issued to Congress, and the panel hopes that the recommendations will be incorporated into physicians' guidelines or into legislation.
The IOM is a private, nonprofit organization that provides health policy advice under a congressional charter granted to the National Academy of Sciences. McCormick was elected to the institute in 1997. As reported in the October 16 issue of Around the School, three more HSPH-affiliated faculty have recently been elected to the institute. They are Johanna Dwyer, adjunct professor of medicine and community health in the Department of Maternal and Child Health; Laurie Glimcher, Irene Heinz Given Professor of Immunology, Department of Immunology and Infectious Diseases; and Walter Willett, Fredrick John Stare Professor of Epidemiology and Nutrition.
McCormick will give a presentation of the IOM
recommendations on October 26 from 12:30 to 1:30 p.m. in Kresge 212. The
report itself can be read on the World Wide Web at www2.nas.edu/iom.
Marie McCormick will present the Institute of Medicine's
recommendations for reducing the perinatal
transmission of HIV on October 26 from 12:30 to
1:30 p.m. in Kresge 212.
