Ala. Admin. Code r. 420-4-1-.11

Current through Register Vol. 43, No. 1, October 31, 2024

Section 420-4-1-.11 - Testing of Pregnant Women for Sexually Transmitted Diseases

(1) Practitioners attending a pregnant woman shall test them at the initial prenatal visit for chlamydia, gonorrhea, syphilis, hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV infections unless the pregnant woman has previously been confirmed to have HIV infection.

(2) Practitioners shall test for:

(a) Syphilis during the third trimester, between 28-32 weeks gestation, regardless of risk factors.

(b) HIV infection at 28-32 weeks gestation, regardless of risk factors, unless a pregnant woman is already confirmed to be infected with HIV.

(c) Chlamydia and gonorrhea at 36 weeks of gestation if the initial testing was positive, signs and symptoms are present, or the pregnant woman is at high risk of infection.

(d) A pregnant woman who declined to test earlier in their pregnancy shall again be offered testing for chlamydia, gonorrhea, syphilis, and HIV during the early third trimester.

(3) Practitioners shall test all pregnant women at the time of labor and delivery for syphilis, HIV infection (unless they are already confirmed to be infected with HIV), and HBV (if no prior testing for HBV or the pregnant woman has signs or symptoms of hepatitis).

(4) If a pregnant woman first presents for care at the time of labor and delivery, practitioners shall test the pregnant woman for chlamydia, gonorrhea, syphilis, HBV, HCV, and HIV infection. (HIV testing is required if the pregnant woman is not confirmed to have HIV infection.)

(5) Refusal of a pregnant woman to permit testing for chlamydia, gonorrhea, syphilis, HBV, HCV, and not previously confirmed to have HIV infection, despite pre-test counseling, shall be documented in the medical record.

(6) Practitioners shall use only those tests for sexually transmitted diseases/infections licensed by the U.S. Food and Drug Administration. Test results for HIV infection shall be confirmed before the patient is notified of her results, except in circumstances to aid the decision to initiate antiretroviral prophylaxis to protect the baby. In such cases, providers shall perform a rapid test for HIV infection on a pregnant woman who presents in labor without previous prenatal care that has not been previously confirmed as infected with HIV. Providers shall perform confirmatory testing after a positive rapid test.

(7) Appendix IV provides the summary table of routine prenatal screening for sexually transmitted diseases.

Ala. Admin. Code r. 420-4-1-.11

New Rule: Filed February 17, 2006; effective March 24, 2006. Repealed and New Rule: Filed May 26, 2011; effective June 30, 2011.

Amended by Alabama Administrative Monthly Volume XXXIII, Issue No. 03, December 31, 2014, Filed November 25, 2014, eff. 12/30/2014.

Adopted by Alabama Administrative Monthly Volume XLII, Issue No. 05, February 29, 2024, eff. 4/14/2024.

Rule 420-4-1-.14 was renumbered to .11 as pre certification filed November 25, 2014; effective December 30, 2014.

Author: Charles H. Woernle, M.D., M.P.H.

Statutory Authority:Code of Ala. 1975, §§22-2-2(6), 22-11A-1, et. seq.