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“Given the enormous advances in the prevention of perinatal transmission of HIV, it is clear that early identification and treatment of all pregnant women with human immunodeficiency virus (HIV) is the best way to prevent neonatal disease and also may improve the woman's health.” (ACOG Committee Opinion Number 418, September 2008)

HIV/STD Testing in Pregnancy:  IT’S THE LAW

Get the Facts: Compare Florida's HIV Testing Requirements for Pregnant Women to ACOG's Recommendations

Florida Administrative Code (FAC) Rule 64D-3.042 requires that healthcare providers conduct routine testing for HIV, Chlamydia, gonorrhea, hepatitis B, and syphilis on all pregnant women, using the opt-out approach, at the initial prenatal care visit and again at 28 to 32 weeks gestation.

  • Florida has a high HIV prevalence among women of childbearing age.

  • HIV/STD testing and rapid testing in labor and delivery are covered by state and private funding sources.

Women who present in labor and delivery or within 30 days post-partum with no record of HIV/STD testing after 27 weeks gestation will be tested using the same guidelines.

  • ACOG Committee Opinion No. 418 states "Women who are candidates for third-trimester testing, including those who previously declined testing earlier in pregnancy sould be given a conventional HIV test rather than waiting to receive a rapid test at labor and delivery (as allowed by state law and regulations)."
  • A documented HIV status is either a negative or a positive. If a woman declines testing prenatally, the delivering hospital is required to test based on FAC 64D-3.042.


A signed consent to test is no longer required. A woman must be notified that she is being tested and that she has the right to refuse any or all of the tests. If she declines, a signed objection must be attempted. If she refuses or is unable to sign it must be documented in the medical record.

  • Using the opt-out approach increases the HIV testing rate.
  • Women are more likely to test based on the providers approach.
  • Best Approach: "STDs can significantly impact your baby's health if you are not treated; therefore, we routinely test for Chlamydia, gonorrhea, syphilis, hepatitis B, and HIV unless you tell us not to."
  • Giving or posting  written material that explains Florida's HIV/STD testing law and why it is important constitutes notification.

 
F.A.C. Rule 64D-3.029 requires that practitioners report the birth of an HIV exposed newborn and a newly diagnosed infant up to 18 months of age to their local county health department’s surveillance office by the next business day of the birth or diagnosis.

Follow this link- to get email notifications regarding activities of Rules and Notices.

  Do your part to reduce the incidence of HIV.

  • Encourage HIV testing as a routine part of health care.
  • Test all women for HIV/STDs in pregnancy using the opt-out approach.
  • Educate women who decline testing on the mode of transmission, risk factors, and the success of treatment to reduce the risk of transmission.
  • Document test results on prenatal records.
  • Make sure that prenatal records are available in labor and delivery to avoid unnecessary rapid testing.
  • Report all HIV exposed babies (birth to 18 month of age) to your local surveillance office by the next business day.

Browse the list of free resource materials in the Resource/Documents/Forms/Educational Tools section and submit a product order form on-line.
 

   FLORIDA  FACTS

  • Over 125,000 Floridians are infected with HIV.
  • Florida is ranked third in the country for cumulative AIDS cases diagnosed for 30 states.
  • Women ages 13+ accounted for 26% of the HIV cases and 33% of the AIDS cases reported in 2009.
  • Florida is ranked second for total pediatric HIV/AIDS cases
    • First for total pediatric AIDS cases
    • Second for total pediatric HIV cases
  • Of the 601 babies known to be born to an HIV infected mother in 2008, 9 are known to be infected.
  • Nine infected babies were identified in 2009; 6 were identified in 2010; and, to date, 2 have been identified in 2011 (updated by the FL DOH 7/13/11).

Source: Florida Department of Health, Bureau of HIV/AIDS. Data as of 2/15/10.

Reminder: Florida law (Florida Administrative Code-Ch.64C-7) requires all pregnant women and infants to be screened for Healthy Start to improve birth, health, and developmental outcomes.

  

Related Links

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ELearning Module: Perinatal Prevention of HIV Transmission presented by Jeanne Sheffield, MD. On-demand, free training opportunity, minimum viewing time is 30 minutes. This evidence-based module explores epidemiology, HIV transmission studies, case studies, HIV & Pregnancy, transmission reduction regimens, modes of delivery, and mother-to-child transmission prevention. The speaker, Dr. Jeanne Sheffield, is an Associate Professor of Medicine at UT Southwestern Medical Center. She is board certified in Obstetrics & Gynecology and Maternal-Fetal Medicine (ABOG), and has extensive experience in Treating and preventing sexually transmitted infections. Provided for you courtesy of our friends at the Texas/Oklahoma AIDS Education & Training Center.                             

National Women and Girls HIV/AIDS Awareness Day (NWGHAAD) is a nationwide initiative celebrated on March 10 every year to raise awareness of the increasing impact of HIV/AIDS on women and girls.

Perinatal Hotline Need answers regarding your patients's HIV test results? Need assistance managing a positive HIV test on Labor and Delivery? Need a referral for your HIV-infected pregnant patient?

Perinatal HIV Guidelines Public Health Service Task Force Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmissions in the United States (May 24, 2010).

 

MMWR: Sexually Transmitted Diseases Treatment Guidelines, 2010  The term sexually transmitted diseases (STDs) is used to refer to a variety of clinical syndromes caused by pathogens that can be acquired and transmitted through sexual activity. Physicians and other health-care providers play a critical role in preventing and treating STDs. These guidelines for the treatment of STDs are intended to assist with that effort. Although these guidelines emphasize treatment, prevention strategies and diagnostic recommendations also are discussed.

CDC HIV Testing Guidelines Quick link to the CDC's Recommendations & Guidelines page.

Women, Children, and HIV Resources on the prevention and treatment of HIV infection in women and children targeted at health workers, program managers, and policy makers in resource-limited settings.

Antiretroviral Pregnancy Registry The Registry is a voluntary prospective, exposure-registration, observational study designed to collect and evaluate data on the outcomes of pregnancy exposures to antiretroviral products.

One Test Two Lives Campaign The One Test. Two Lives. campaign from the Centers for Disease Control and Prevention (CDC) focuses on ensuring that all women are tested for HIV early in their pregnancy.

The American College of Obstetricians and Gynecologists ACOG's HIV Home Page provides information about women and HIV, routine HIV screening as a component of gynecologic and obstetric care, and includes specific information about HIV and its impact on women of color.

HOT OFF THE PRESS! HIV/AIDS Prevention Bilingual Glossary  Find Spanish equivalents for English words and vice versa. Rate the translations provided. Use the tag cloud to find commonly searched terms.

  
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