Michigan has seen an increase in cases of congenital syphilis (CS) and perinatal HIV in recent years. Both CS and perinatal HIV infections are 100% preventable and result from inadequate prenatal testing and treatment. Any case of CS or perinatal HIV is considered preventable and a failure of public health. Health care providers should be cognizant of this increase and take the necessary steps to ensure proper testing and treatment of pregnant patients. In Michigan, many cases of CS are attributable to pregnant women not receiving comprehensive treatment according to CDC guidelines prior to delivery. The clinical manifestations of syphilis and clinical outcomes of untreated infection can be referenced here.
In December 2018, the Michigan Legislature updated its Perinatal HIV/STD testing laws. These changes have aligned Michigan’s testing laws with the Centers for Disease Control and Prevention guidelines for HIV and STD testing during pregnancy and at delivery.
The updated law (Michigan’s House Bill 6022) states:
- All pregnant women shall be tested for HIV, hepatitis B virus (HBV), and syphilis at their first prenatal visit (unless the patient refuses).
- All pregnant women are to be retested for these infections during the third trimester. The Michigan Department of Health and Human Services recommends this to occur at 28 weeks, or as soon thereafter as possible, to allow for timely treatment or referral to services.
- Pregnant women who present for delivery without documentation of previous testing or declination and reason for refusal are to receive stat testing. Patients can consent to an HIV test verbally or in writing, a separate consent for HIV testing is no longer required. A patient who provides general informed consent for medical care is considered to have consented to an HIV test. If an HIV test is declined, providers are required to document refusal of testing in the patient’s medical record.
Health care providers have a critical role to play in ensuring the health and well-being of women and babies in Michigan. Michigan’s recent law change aims to identify infections early, treat infections according to published guidelines, and work with public health to ensure that sexual partners are also tested and treated. If you have any questions about congenital syphilis or perinatal HIV, please contact Aleigha Phillips, MDHHS Congenital Syphilis/Perinatal HIV Coordinator, at 313-456-1330.
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