Proposed Legislation to End Written Consent for HIV Testing in Massachusetts Sparks Controversy

Massachusetts still requires written consent before a patient can be tested for HIV. Now, two bills before the Senate there would require health care providers to verbally discuss the test; outline treatment options if it comes back positive; recommend that negative but at-risk individuals undergo periodic testing; and advise patients they have the right to decline HIV testing.

The measures are sponsored by state Sens. Patricia Jehlen and Robert O'Leary, both Democrats. O'Leary's bill also mandates the state Department of Public Heath conduct a study on how to best reach those who are at increased risk for HIV but not getting tested.

The legislation recently was endorsed by the Boston Globe in an editorial and many health care providers and organizations support it. It also complies with CDC's 2006 non-binding recommendation that general consent for medical care should be considered sufficient.

But some LGBT and HIV/AIDS groups remain opposed. Bennett Klein, director of Gay & Lesbian Advocates & Defenders, testified before a House hearing last week that there is no evidence to suggest that written consent is a barrier to HIV testing. The bills leave open the possibility some people will be tested without their knowledge, or without believing the test is voluntary, he argued. AIDS Action Committee also is not endorsing the legislation.

According to Jehlen's office, testing rates at San Francisco General Hospital rose by 44 percent after written consent for HIV testing was lifted. And the number of HIV-positive tests at SFGH increased 67 percent. As many as 20 percent of Massachusetts residents are HIV-infected but do not know it because they have not been tested, her office said.

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