AIDS Action Council Opposes HIV Prevention Act Of 1997
Coburn Substitutes Politics of Fear for Prevention
March 13, 1997
Contact: José Zuñiga
WASHINGTON, DC - AIDS Action Council, the nation's leading AIDS advocacy organization, today denounced the HIV Prevention Act of 1997, championed by Rep. Tom Coburn (R-Okla.), as an attempt to federalize policies that do nothing but stigmatize and punish people living with HIV/AIDS.
In order to force state compliance with his bill, Coburn proposes that federal Medicaid funds be withheld from states that do not implement its provisions. These federal resources, when pooled with state Medicaid funding, finance basic health care services for approximately 37 million Americans, including 53 percent of adults and 90 percent of children living with AIDS.
"In reality, none of the provisions in the 'HIV Prevention Act of 1997' have anything to do with preventing the spread of HIV," said Aimee Berenson, AIDS Action Council's director of government affairs. "The only way to prevent people from becoming infected with HIV is to provide them with straight-forward information about how HIV is transmitted and how they can modify behaviors that may put them at risk. This bill does nothing to address prevention at all. Instead, Rep. Coburn is promoting a hodge-podge of coercive testing-related policies, under the pretense that identifying people who are HIV-positive, in and of itself, will somehow prevent others from being infected."
Opponents of the bill are particularly dismayed that Coburn, a doctor, promotes nonconsensual and coercive testing, as opposed to education and destigmatization of testing, as a sound public health approach to "disease prevention." According to Berenson, the Coburn bill claims to "protect" medical professionals by allowing them to refuse to treat patients who have not been tested for HIV, instead of putting the focus where it should be - on requiring all medical professionals to talk to their patients about HIV, counsel them about risk reduction, and encourage patients to be tested voluntarily.
"Every public health and medical professional in this country knows that the only way for health professionals to protect themselves from accidental exposure to HIV and other blood-borne diseases is to comply with the `universal precaution' guidelines when treating all patients," said Berenson. "Rep. Coburn's approach ignores all sound medical practice and principle, fosters miscommunication and distrust between patients and health care providers, and does nothing to actually prevent either from becoming infected."
Despite the fact that all states already have partner notification programs, the Coburn bill purports to somehow create these programs anew. In fact, the only "new" provision requires the federal government to collect the names of everyone who tests positive for HIV in each state and distribute the list to other states, ostensibly for the purpose of tracking down "partners" across state lines. AIDS Action Council is concerned about wasting federal and state resources on such a spurious "prevention" effort, as opposed to increasing funding for current HIV prevention programs that are proven to be effective.
"If Rep. Coburn really wanted to prevent HIV infections" Berenson suggested, "he would be fighting to increase funding for the CDC's HIV prevention programs, programs that create partnerships with state and local public health departments and local communities to implement cost-effective prevention strategies that respond to each community's unique needs."
Perhaps the most disturbing "prevention" provision in Coburn's bill claims to "protect" the victims of sexual assault by testing the alleged offender. The Crime Control Act of 1994 already provides for victim-controlled court orders in federal sex offense cases. In addition, states are free to pass such laws if they deem fit, and many have.
"Rep. Coburn thinks he knows better," remarked Berenson. "His bill imposes a barely-coherent process on all states that does not give the victim control over whether or not testing occurs, provides nothing by way of counseling, testing or care for the victim, and requires that the defendant's test results be released to just about every attorney and state entity one could imagine, without any consideration of the victim's rights to confidentiality."
Furthermore, although the HIV Prevention Act of 1997 does pretend to address confidentiality issues, it doesn't provide even minimalist protections against breaches of confidentiality.
"Again, Coburn doesn't get it," said Berenson. "If he were truly concerned about confidentiality, Rep. Coburn would work to criminalize breaches of confidentiality and prohibit discrimination in health care insurance, housing, and employment based on HIV status. Coburn's bill merely expresses the `Sense of Congress' that confidentiality `must' be observed at all times in carrying on the provisions of the Act. However, a Sense of Congress is not binding and cannot be enforced by law"
AIDS Action Council asserts that the HIV Prevention Act of 1997 replaces education and personal responsibility with "Big Brother" intrusion and control that mandate "one size fits all" solutions from Washington.
"Many of these policies have been resoundingly rejected by medical, public health, and prevention experts nationwide," added Berenson. "Others are already current law, and the rest merely tie the hands of states and communities trying to respond to the specific local needs posed by the HIV epidemic. It is time to call Rep. Coburn on his real agenda and reject the politics of fear in favor of the policies of real prevention."
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This article was provided by AIDS Action Council.