A 33-year-old woman comes to your office because she thinks that she is pregnant. A urine pregnancy test in the office is positive. She states that she would like you to be the physician responsible for her prenatal care. You begin taking a thorough history, which reveals that the patient currently has several sexual partners and is not sure who actually fathered the child. You explain to her that HIV testing is a routine part of prenatal screening and that given her sexual history, she is at an increased risk of contracting the virus. She becomes slightly offended and refuses to be tested for HIV. What is the best response to this patient?

Question

A 33-year-old woman comes to your office because she thinks that she is pregnant.  A urine pregnancy test in the office is positive.  She states that she would like you to be the physician responsible for her prenatal care.  You begin taking a thorough history, which reveals that the patient currently has several sexual partners and is not sure who actually fathered the child.  You explain to her that HIV testing is a routine part of prenatal screening and that given her sexual history, she is at an increased risk of contracting the virus.  She becomes slightly offended and refuses to be tested for HIV.  What is the best response to this patient?

Quizplus · Accepted Answer

Explanation: The American Medical Association has recommended that physicians should support routine HIV testing when indicated to protect patients and to avoid injury to third parties. As a result of substantial medical and social advances, physicians are no longer required to obtain written consent for HIV testing unless required by law. However, physicians should document the conversation about HIV testing in the chart. This patient is certainly at high risk for HIV infection. While it is recommended that all pregnant women be screened for HIV, this patient does retain the right to refuse this test. (Choice B) The Center for Disease Control does have guidelines regarding the reporting of HIV/AIDS, but there are no regulations that require testing pregnant women for HIV against their will. (Choice C)This patient has a right to refuse HIV testing, and refusing to treat this patient without offering a suitable alternative would constitute patient abandonment. (Choice D) There are no laws requiring that pregnant women be tested for HIV. (Choice E)Child Protective Services should not be notified because this patient has a right to refuse the HIV test. Educational objective: Universal HIV screening for pregnant women is recommended, but women do retain the right to refuse testing.

A 33-Year-Old Woman Comes to Your Office Because She Thinks