Baye's Rule is highly questionable here because the true seroprevalence of HIV is unknown in the US. The headline of your article,

"New Jersey Requires H.I.V. Test in Pregnancy"

is bullshit too, unless whoever wrote the article had a brainfart when they wrote,

all pregnant women in the state will be tested for the virus as part of their prenatal care unless they object.

Informed consent is still part of our medical system, no matter what you fantasize.

Routine testing of newborns usually includes phenylketonuria (0.01%), thyroid function (approximately 1 per 4000 births for congenital hypothyroidism) and sickle cell disease (approx 8% of the African American population carry the trait).

So, for instance, by your analysis, screening for PKU should also be dropped because of Baye's Rule. Explain that to the parents of a severely retarded child whose disease could have been prevented by the use of an inexpensive test (CPT code: 84030, cost $10.19).

HIV can also be prevented easily and inexpensively if the status of a mother can be established during the course of her pregnancy. The cost of preventing (by screening) mother-to-child transmission is miniscule compared to the cost that would ensue from those cases that would occur as a result of not screening.

Oh, and before you jump on me about sensitivity and specificity let me explain how the testing works:

Standard HIV antibody (ELISA) tests are at least 99.5% accurate when it comes to detecting the presence of HIV antibodies. This high level of sensitivity however means that their specificity (ability to distinguish HIV antibodies from other antibodies) is slightly lowered. Once an individual is out of the window period, it is more likely that they will receive a false positive result than a false negative.

Any HIV positive result given by an ELISA test must therefore be confirmed using a second test. Secondary tests include:

Western Blot Assays – One of the oldest but most accurate confirmatory antibody tests. It is complex to administer and may produce indeterminate results if a person has a transitory infection with another virus.

Indirect Immunofluorescence Assay – Like the Western blot, but uses a microscope to detect HIV antibodies.

Line Immunoassay - Commonly used in Europe. Reduces chance of sample contamination and is as accurate as the Western Blot.

A second ELISA – In resource-poor settings with relatively high prevalence, a second ELISA test may be used to confirm a diagnosis. The second test will usually be a different commercial brand and will use a different method of detection to the first.

When two tests are combined, the chance of getting an inaccurate result is less than 0.1%.

http://www.avert.org/testing.htm

I've worked in the field of Infectious Diseases for 25 years, the last 8 in AIDS research. I am mortally tired of seeing young people coming into our clinic as a result of the reduction in funding of AIDS education. If we were to discover a successful vaccine tomorrow I would gladly retire to work in a greenhouse somewhere. And everyone else I work with feels the same.

To be labeled as having AIDS in this country means you *will* take the poison until you are dead.

This is ignorant bullshit too Bucky. We have patients who refuse treatment. But they do it after being informed of the risks and benefits, which is as it should be.

On the other hand, health care professionals have a right to know who and what they are dealing with in the case of fatal diseases.

This is not the reason for screening. Health care workers are routinely educated on Universal Precautions against the transmission of all bloodborne diseases.

http://www.cdc.gov/ncidod/dhqp/bp_universal_precautions.html

My institution had the foresight to institute these policies more than a year before the CDC included them in its guidelines.

Someone who tests positive can get tested again, someone that gets an accidental needle stick with infected blood may not be so fortunate.

Medical institutions have well-established protocols for dealing with needle-stick injuries that include adequate testing and treatment for all bloodborne illnesses.

It is in fact the inability to know before having sex that leads to it's spread.

How does your "fact" explain the infections that result from contaminated needles in the IV drug using population (needle-exchange programs work) and in those who must receive concentrated blood products such as hemophiliacs? Were they having sex with each other?