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Routine Opt-Out HIV Testing in 2011: The Road to Civility Is Paved With Forgiveness

December 6, 2010

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2011: Restating Key Routine HIV Testing Arguments With Clarity and Intelligence, Hold the Static

The new year will bring a fresh opportunity to restate the essential points we made in support of routine HIV testing in Massachusetts. These points remain potent and timely. They resonate.

  1. Routine opt-out HIV testing will literally save lives. As more people are tested for HIV and diagnosed earlier, they can begin treatment sooner and hopefully live longer and healthier lives. This will save both money and resources from an already-strapped medical system.
  2. Routine opt-out HIV testing will help break the cycle of new infections. Studies show that up to 70 percent of new HIV infections are transmitted by undiagnosed individuals, and that people who know they are HIV positive are 3.5 times less likely to infect others.
  3. Routine opt-out HIV testing will move us forward in ending the stigma that still surrounds HIV. Thanks to advances in medications, research and science, HIV is no longer the death sentence that it was 20 years ago and has become a much more manageable condition, in that way not unlike diabetes. The availability of and access to effective and risk-neutral HIV medication regimens allows the newly diagnosed to manage life with HIV in ways quite different than, say, 15 years ago. And because the newly diagnosed are likely to remain healthy for many years to come, they are also more likely to make their HIV status known to others. Yo, HIV Stigma -- catch you on the flip side!

And I intend to do in 2011 what I did not do this year past -- demystify and humanize routine opt-out HIV testing. What will routine opt-out HIV testing sound like? This script (embellishments added for dramatic purposes only) is presently offered by medical practitioners in clinics, hospitals and other medical testing environments where routine HIV testing is in place:

"Mr. Perlmutter, we'll be running some blood work today. The FeelGood Clinic also performs routine screening for HIV on all patients and we'll be doing that as part of your visit today."

"But wait one minute here, Doctor," pipes in a now feisty Accidental Activist, amazed that someone is actually talking about HIV. "I was tested a few years ago and I'm sure I'm still fine."

"We run routine HIV screening because of our desire to keep patients like you healthy and because there are excellent treatment options available for HIV. You may decline the test and it will not affect the care you receive at the clinic today."


Now was that so bad? To me, this script reads and feels like a breath of fresh air on the most glorious of May days. Rather than keeping HIV lurking behind a shrouded veil of denial and stigma as The Virus-We-Prefer-Not-To-Talk-About -- and don't -- states who have adopted routine opt-out HIV testing have entered a new age of HIV in which health care providers are better informed and knowledgeable about the virus because it becomes part of their daily standard operating procedures. Those diagnosed are better prepared to face the consequences of an HIV diagnosis because routine opt-out testing levels the playing field regarding HIV testing, diagnosis and treatment options.

There remain those who resist letting go of written informed consent HIV testing. They see it as the gold standard, as the end-all be-all, and contend that it is still an effective testing protocol. I fought so hard to see routine opt-out HIV testing enacted as the law in Massachusetts because I know firsthand that none of their arguments about written informed consent are true. I found out the hard way.

A little known fact about me: Not only am I a graduate with honors from The School of Letting Go, I am also the Headmistress! To those interested in matriculating, I am always available to discuss coursework and degree programs. Change is good, really it is. And routine opt-out HIV testing is the essential change we need to bring us into the future of HIV.

Breathe it in, breathe it out, let it go. I wish you all good health, and well-punched soles, in the year to come.

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Ed Perlmutter was diagnosed with HIV in July 2006, and has been receiving HIV therapy through a National Institutes of Health (NIH) study since September 2006. He lives with his partner in an old farmhouse on the city limits of Boston, in the woods, amongst critters and varmints and dozens of varieties of dahlias. When he is not raising awareness as an accidental activist, he works as a manufacturing manager for a publishing company in Boston.

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This article was provided by TheBody.
See Also
HIV/AIDS Year in Review: Looking Back on 2010 (and Ahead to 2011)
Quiz: Are You at Risk for HIV?
10 Common Fears About HIV Transmission
More Viewpoints on U.S. HIV Testing Policy

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