Regarding HIV clinical care, my friend James always says, "stay close to the center of the merry-go-round." And it's great advice. Stay close to the center and gravity keeps you balanced and secure, in the right spot, even though you're spinning fast, round and round. Shift out from the center and all bets are off. For the past six and one-half years, I've had my ass firmly planted at the center of the merry-go-round, right where I need to be. And I've been holding onto that spot for dear life, and there I've received the best HIV clinical care I could possibly imagine.
On April 27, 2012, with the stroke of a pen and little fanfare or media attention, Massachusetts Governor Deval Patrick signed into law Senate Bill 2158 ("An Act Increasing Screening for HIV"), thus removing a decades-old requirement to obtain written informed consent prior to HIV testing. The Commonwealth's new law now allows for an individual to give verbal informed consent before receiving an HIV test. Until the law took effect on July 26, 2012 (again with little fanfare or media note), Massachusetts was one of only two states that had mandated written consent, a testing model which many clinicians and testing advocates, myself included, believed posed a barrier to testing.
If it seems too good to be true, it probably is.
In retrospect, I wish someone had reminded me of this obvious truth last fall. I'd been miserable at my former job -- underutilized, marginalized, bored -- you name it. I did not know what to do, where to turn, or how to move forward. I had just turned 50. And then the phone rang.
A "funny" thing may happen on the way to bringing HIV testing law in Massachusetts into the 21st century - NOT A DAMNED THING. ZERO. ZILCH.
If for no other reason (and there are many other salient ones), the encounter described here explains precisely why routine opt-out HIV testing is the only testing method that should be instituted in Massachusetts. No one should settle for anything less; I certainly will not.
My entry in the 2011 "Fight HIV Your Way" contest, sponsored by Bristol-Myers Squibb and its first-line protease inhibitor Reyataz, has been selected as one of 25 national third prize winners. I entered the contest this past February to help raise awareness about HIV testing issues in general and specifically the need for routine opt-out HIV testing here in Massachusetts, which now holds the dubious distinction of being the only state in the United States where Written Informed Consent testing is the only means to be screened for the HIV virus.
Massachusetts, the state in which I live, boasts many firsts -- among them, the first state to recognize marriage equality (2004), the first typewriter (invented by Charles Thurber in Worcester in 1840), the first Fig Newton cookie (invented by James Henry Mitchell in Newton in 1881), and the first subway (opened in Boston in 1898 and still operating the same nineteenth-century trolley cars).
I delivered testimony in favor of a Verbal Informed Consent HIV Testing Bill, now making its way through the Massachusetts Legislature, to a packed hearing room on Tuesday, April 5, 2011. While this bill is neither the Routine Opt-Out HIV testing model nor the bill I would support in a perfect world, last time I checked we live on a rather imperfect globe. I decided it was time to stop waltzing in the Mosh Pit, where things can get messy. Rather, my testimony took me on the High Road, a road less traveled, at least in the experiences thus far of An Accidental Activist.
I did not get into this Accidental Activist thing to make friends, but rather to influence people and to help save lives by shifting HIV testing to a Routine Opt-Out paradigm. I wish to affect change in a public health policy -- at least in the state where I live -- that currently is about as relevant as a leisure suit.
I had the pleasure of spending a recent weekend in Los Angeles, and for someone who has lived in New England for more than 27 years I'm struck each time I visit. LA seems very much like stepping into our cultural future. LA still has a refreshing and disarming new frontier feel, like anything is still possible there. If that sounds hokey, so be it.