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Metko's walls are covered with black-and-white fliers advertising punk rock bands. He has a Macintosh computer, a TV with Nintendo games scattered under it, and a high-quality stereo system. A red, white, and blue "election official" name tag stands out on his door. "Metko" is scrawled with determined pen, and under it is printed, "Hello. May I help you?" Metko has slashed out the word "help" and replaced it with "fuck." Godzilla models are frozen in the act of pouncing all over the room. A picture of his mother, blond and serious-looking, sits on one of his tables.
Pornography magazines -- the only things in his room that his grandmother doesn't move, he says -- leak from under his bed.
"My grandmother made it a rule that there's no sex in the house. But that's a rule that gets broken sometimes," he says, spreading his arms and smiling impishly.
Metko, who lost his virginity when he was 14, swears that he told each of his 15 or so lovers his HIV status and that he changes his condom every half-hour during prolonged sex to protect his partner. So far, he says, not one has changed her mind about him after hearing the news.
He looks down at his hands blankly. "I'm such a hopeless romantic," he says. "But God, I think I'd die if I couldn't have sex."
Metko says all his friends know he has AIDS and are very supportive, but his grandparents refuse to tell anyone.
"It's the "eww' factor, I guess," he says. "My grandmother's friends can't read or speak English. They're not the most informed."
In the silence, he listens to his grandparents fighting in the next room. Metko smiles.
"They've been yelling at each other every day for 40 years," he says. "Pure, unadulterated hatred -- it's beautiful."
He rummages in his room until he produces a small bag of marijuana. He empties a can of Coca-Cola and pokes holes in the top to make a temporary pipe.
"Our house always smelled like pot -- my mom used to grow it," he says nostalgically, breathing out marijuana smoke in small puffs. Because Metko's mother was addicted to heroin, she was likely part of the 53 percent of HIV-transmitting California mothers who contracted HIV from injection drug use or from heterosexual contact with an injection drug user. "I have no complaints. It wasn't her fault I got HIV. She didn't know when she had me."
Metko's surprising lack of bitterness demonstrates a personal strength that shouldn't be necessary. With the prevention methods available today, HIV testing of every woman could prevent the transmission of HIV to innocent newborns from ever happening again.
An HIV test costs $3 to $5, whereas the average lifetime charges for the care of a child born with HIV is estimated at $491,936.
According to the California Department of Health Services, approximately 6,530 HIV-infected women gave birth in the United States in 1993. An estimated 1,630 of their infants were HIV-infected. In 1995 an estimated 89 infants were born with HIV in California. Worldwide, more than 1,600 children are born with HIV every day.
More forgotten children.
California law since 1995 requires prenatal care providers to offer HIV counseling and testing to every pregnant woman during prenatal care.
California law also requires that a physician obtain a blood specimen from a pregnant woman before or at the time of delivery. Assemblyman Robert Pacheco (R-City of Industry) introduced a bill last year that would require doctors to test the blood specimen for the presence of antibodies to HIV. It was known as the "baby AIDS bill," but it was vetoed by Gov. Gray Davis in September 2000. New York and Connecticut are the only states that have mandatory testing.
Congress also recently considered a bill proposing mandatory testing for all mothers or newborns, but the bill only passed into law with a compromise: It provides financial incentives for states that test all newborns or all newborns born to a mother of unknown HIV status, or that demonstrate they are making significant progress in reducing perinatal transmission. The bill provides $4 million for the first year for activities of any kind related to the prevention of mother-to-child transmission.
The Elizabeth Glaser Pediatric AIDS Foundation in Santa Monica opposes mandatory testing of women, believing that it damages the cooperative relationship between a mother and a health care provider and makes at-risk women feel too threatened to seek prenatal care at all. Instead, the foundation supports universal, routine, voluntary testing of pregnant women.
"That's the basic standard of care every physician should provide, without a law making it mandatory," says a representative of the foundation.
The U.S. Public Health Service recommended universal counseling and voluntary HIV testing of all pregnant women in 1995. Since then, the combination of testing and drugs has created a true AIDS success story -- a 75 percent decline in pediatric AIDS cases in the last five years.
Despite the progress, however, children are still becoming infected: In 1999, the Centers for Disease Control estimated that 300 to 400 babies will be born with HIV infections each year in the United States.
The largest problem, of course, stems from women who receive no prenatal care. CDC data shows that 15 percent of HIV-infected women in the United States receive no prenatal care, compared to only 2 percent of women in the general American population.