A routine bill updating communicable disease laws unanimously passed a Colorado House committee Monday, punctuated by a rhetorical poke in the eye by an AIDS activist over a morality firestorm ignited in the Senate. Yet it was the testimony of a humble Denver nurse that brought down the house.
Sen. Dave Schultheis’ Feb. 25 comments on SB 179 that HIV testing of pregnant women rewards promiscuity and that HIV-positive babies are punishment for their wayward mothers set off a four-day media food fight, with the Colorado Springs Republican eventually blaming Rocky Mountain News reporter Lynn Bartels for the fallout.
Alluding to Schultheis’ remarks, activist Jeff Thormodsgaard of the Colorado Organizations Responding to AIDS, a consortium of 25 health care, GLBT and hospice groups, threw down the gauntlet.
“HIV testing for pregnant women is not a moral issue. … We wanted to testify in a public hearing to address some of the comments made in the Senate about this very issue and speak to the moral issue and the stigma those comments seek to continue.”
Conservative Republican members of the state House Health and Human Services Committee wisely didn’t take the bait. None of the lawmakers asked a question following his prepared testimony.
Thormodsgaard’s activist-accented clobbering of the committee was in sharp contrast to the velvet hammer of a Denver Children’s Hospital registered nurse, Kay Kinzie.
The immune-deficiency program pregnancy coordinator told the committee, “The majority of women living with HIV in the U.S. — either who know they are infected or who are as yet uninformed about their status are — are in their childbearing years.”
However, with recent medical breakthroughs, mother-to-child HIV transmission are preventable and have been reduced to less than 1 percent with appropriate treatment, thus the importance of screening mandates.
Kinzie said in over a decade of working with pregnant HIV-positive women that the treatment benefits are greatly diminished 48 hours or more after birth.
It was the nurse’s softspoken testimony that was a more devastating disassembling of Schultheis’ comment — that infected babies would cause families to “see the negative consequences of that promiscuity” — than any of the other witness statements or the mountains of public recriminations:
Within our program at Children’s Hospital, we are also working with HIV-positive children, most of whom received the infection from mother-to-child transmission. Some of those children are in their mid-twenties now and are living healthy productive lives and choosing to have their own children who are healthy and uninfected. But I think that if you had given any of those kids the opportunity to live with or without this illness they would certainly choose the latter.
“An important gap to close”
The bill, co-sponsored by Sen. Lois Tochtrop, D-Thornton, and Rep. Sara Gagliardi, D-Arvada, seeks to revise eight state laws on testing, treating and defining communicable diseases:
• requires all women to be tested for HIV during their first trimester of pregnancy, or when entering a hospital for delivery if not tested during pregnancy, unless a woman declines the test;
• allows state and local health officers to detain a person diagnosed with tuberculosis without a court order for up to five days and specifies procedures for seeking a court-ordered detention;
• clarifies the prohibition on working in food preparation when affected by an infectious disease;
• allows the State Board of Health to adopt rules for controlling infectious disease;
• creates an exception to the misdemeanor offense for violating a State Board of Health rule concerning infectious disease by allowing certain health professionals to be subject to a civil penalty for such a violation;
• defines “sexually transmitted infection” and replaces out-of-date medical terminology;
• repeals provisions concerning prescriptions for sexually transmitted infections and exemptions for reporting the personal information of research subjects participating in medical research studies on AIDS or HIV; and
• modifies the membership requirements of the HIV/AIDS Prevention Grant Program Advisory Committee.
In addition to Kinzie and Thormodsgaard, each of the other witnesses, all in support of the bill, provided the committee with a sober analysis of the public health threats facing the state, especially for pregnant HIV-positive women.
Dr. Ned Calonge, the state’s chief medical officer, said the bill is an important step forward to move Colorado into modern-day infectious disease and epidemiology practice.
“We know from birth certificate data that up to 15 percent of women in Colorado are not currently being tested for HIV,” said Calonge. “We feel this is an important gap to close with this legislation.” He noted that Colorado law already requires mandatory syphilis testing of pregnant women, which enables early treatment to prevent transmission in the baby.
With early intervention of anti-retroviral treatment infected children can expect normal life spans, said Calonge.
March of Dimes Colorado chapter representative Scott Matthews echoed his support for the bill, reminding committee members that 50 percent of pregnancies are unintended. Matthews explained that any legislation that improves testing and outreach to pregnant mothers dovetails with the group’s charge to prevent birth defects and infant mortality.
Approximately 1,000 HIV-AIDS patients are managed each year by the Denver Public Health Department, according to its director, Dr. Chris Urbina, and of those people, five to 10 are pregnant women. Urbina noted that because of early intervention, the department has had zero cases of infant HIV transmission.
As encouraging as those statistics are, not everyone is on board with mandatory testing.
After bawling out the House committee for the political sins of Schultheis, HIV-AIDS advocate Thormodsgaard noted that some undisclosed CORA members were not supportive of the bill, even after a patient opt-out clause was added in the Senate to soften the testing requirement.
The bill passed 10-0 with no vote by Rep. Cindy Acree, R-Aurora who was absent. SB 179 moves to the House committee of the whole. If it passes the House, it will go to the governor for approval.