New York: HIV Testing Regulations Debated

On April 19, health experts and community advocates gathered at Harlem's National Black Theatre to discuss whether current state law is preventing more widespread HIV testing. With the rise of rapid HIV tests, some officials believe the 1988 law requiring voluntary and informed consent, written documentation of that consent, and pre- and post-test counseling impedes testing.

Dr. Thomas R. Frieden, New York City's health commissioner, said he supports changes to the law. Frieden said he wants to "modernize HIV testing" by expanding its use in primary care practices, emergency rooms and other settings where providers may be unable to satisfy consent and counseling requirements. Echoing his peers at the state and federal level, he pressed for increasing the amount of HIV testing for at-risk populations.

Supporters of expanded testing point to data showing that people who know they are HIV-positive are less likely to infect others. "People who know their status are less risky and the majority of infections are spread by people who don't know their diagnosis," said Frieden. He noted that roughly one-quarter of the city's 4,000 newly diagnosed HIV cases last year also had a concurrent AIDS diagnosis, meaning they were infected for years without knowing it.

Soraya Elcock of the AIDS service organization Harlem United agreed that expanded testing might have detected those 1,000 or so cases, but she opposed core changes to the law. Other measures, such as shortening the consent form, could reduce the requirements that some believe are burdensome, said Elcock.

While the law may hinder testing, Dr. Paul Galatowitsch, former director of community outreach and research development at New York University's Center for Health, Identity and Prevention Studies, said greater obstacles could be providers who are not trained to use rapid tests and insurance companies that are not paying for them.

Back to other news for April 26, 2005