The vast majority of HIV-positive children were infected by mother-to-child transmission. For that reason, the Department of Health has focused on educating women and health care providers on the importance of HIV testing for pregnant women and the availability of treatment. As a result, Florida has made great strides in reducing pediatric HIV/AIDS; the number of newly diagnosed HIV and AIDS cases in children under 13 years of age has declined 96 percent since 1992. In 2005, the law was changed to implement "opt-out" testing. Pregnant women are offered prenatal testing for a number of diseases, and HIV is included in that routine testing at the initial prenatal visit and again at 28 to 32 weeks. The woman may chose to decline, or opt-out, of any and all tests. She must then sign a Statement of Objection indicating which tests she is refusing. Previously, over 90 percent of women receiving prenatal care received an HIV test, and it is believed that this change will increase that number.

The Targeted Outreach for Pregnant Women Act (TOPWA) program provides women of childbearing age information on HIV prevention, offers them free HIV testing and free pregnancy testing, and assists pregnant women to access prenatal care and other services. TOPWA also addresses issues that may place pregnant women at risk, such as homelessness, domestic violence and substance abuse. Providers assist with transportation to prenatal care appointments, translation services for non-English speaking women, and assistance in signing up for Medicaid and other programs.

The Florida/Caribbean AIDS Education and Training Center (AETC) works with health care providers to educate them on Florida's HIV testing laws and provides training on the latest treatment recommendations to prevent mother-to-child transmission. The Center works with hospital labor and delivery units to assist them in developing protocols for offering HIV testing to women of unknown status. AETC also creates protocols for the care and treatment of HIV-infected delivering women, as well as implementing rapid HIV testing.



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