New York: Proposal -- HIV Tests During Doctor Visits
April 18, 2006
A proposed state law to make HIV testing easier and allow health officials to use patient medical data to ensure treatment and care divided some 60 Staten Island activists at an April 10th forum. The forum was the fifth of six scheduled in all New York boroughs by the proposal's author, Dr. Thomas Frieden, New York City health commissioner. One in six people with HIV/AIDS in the United States lives in the city.
Frieden wants HIV testing done during routine doctor exams and wants state law changed so a patient's verbal consent could authorize testing. Current state law requires pretest counseling and a patient's written consent for testing and acknowledgment of the implications of a positive result. Frieden's proposal would also allow health officials to contact patients who stop seeing their doctors or counselors.
"We want to reduce barriers to testing," said Frieden. While 70 percent of the city's 100,000 HIV patients get routine care, about 20 percent remain undiagnosed and go without treatment, according to the city Health Department. Several speakers said many residents receive an HIV diagnosis only after they develop AIDS.
"It would be implementing de facto mandatory testing," said Diane Arneth, executive director of Community Health Action of Staten Island. "The biggest barriers are the attitudes and beliefs of doctors [on Staten Island]," she said. Doctors, she said, often tell patients who ask for an HIV test: "You don't need an HIV test, you're married. You don't need an HIV test, you're not gay."
By normalizing HIV testing, said Frieden, the city can reduce stigma or prejudice in doctors' decisions about who needs testing.
Many people who do not seek treatment are minorities who are likely not to speak English and may be struggling with mental illness and substance abuse, said the Rev. Terry Troia, executive director of Project Hospitality. She supported routine testing but added: "Let's look at the structures of how care is delivered."
Staten Island Advance
04.15.06; Lisa Schneider
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.