New York: Overhaul Urged for Laws on AIDS Tests and Data

New York City's Health Commissioner detailed proposals yesterday that call for state HIV testing consent and medical privacy laws to be changed to facilitate testing and help people with HIV/AIDS find effective treatment. Developed in the 1980s, the state laws were meant to shield the identity of patients and encourage testing when the disease and HIV/AIDS patients were greatly stigmatized.

Under current state testing laws, a patient must give written consent to receive an HIV test, and physicians must detail reasons why a patient may not want to consent to testing. Dr. Thomas Frieden urged the state to make HIV testing a routine part of medical care; allow verbal instead of written consent to HIV testing; and do away entirely with counseling patients why they may not want testing.

Detailed medical data reported by laboratories to city and state health departments are patient-specific. But due to state privacy laws, authorities lack the legal capacity to utilize that information to contact HIV/AIDS patients or, even if officials know a patient is dying, to offer assistance with their treatment. Frieden wants state law changed to allow public health officials to consult directly with patients and their doctors.

In 2004, 1,038 patients already had AIDS when they were diagnosed with HIV, said Frieden. Black men with HIV are six times more likely to die of the disease than white men, and black women are nine times more likely to die than white women. In order to reduce such disparities, he said, delays in diagnoses must be overcome, and the data collected must be allowed to be used to direct treatment, he said.

Freidan's proposals met some skepticism at yesterday's New York State AIDS Advisory Council meeting, especially with respect to loosening privacy protections. State Sen. Thomas K. Duane (D-Manhattan) said HIV/AIDS still carries stigma and that it would be imprudent to move too quickly to change the laws. Privacy would remain paramount, said Frieden, who believes patients and doctors would eventually welcome the voluntary system.

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