Officials, Providers at Odds on HIV Test
Sunday, June 4, 2006; 12:43 PM
NEW YORK -- More than 100,000 New York City residents have HIV, and 20 percent don't know it. Many sicken and die without learning their status.
New York City health officials want to reverse the trend by making it easier for doctors to administer HIV tests and to monitor the care of people who have the virus. But the issue has drawn outrage from AIDS service providers.
The dispute coincides with the 25th anniversary of the AIDS epidemic. On June 5, 1981, federal health authorities found that five gay men in California had contracted a rare kind of pneumonia, the first recognized cases of what later became known as AIDS.
At issue in 2006 in New York is whether it is time to start treating AIDS more like other communicable diseases or whether AIDS still carries so much stigma that issues of privacy and confidentiality must remain paramount.
The changes would abolish a requirement in New York for separate written consent for an HIV test and permit public health authorities to share information about matters such as viral load and drug resistance with an HIV patient's doctor _ information which can help doctors treat their patients effectively.
New York City Health Commissioner Dr. Thomas Frieden made his case for the changes at a series of public meetings this spring.
"As long as HIV testing is different from all other testing in the medical care system it's not going to be part of routine medical care," he said at a Harlem Hospital forum.
His audience largely disagreed; it included representatives of civil liberties groups and organizations that serve people with AIDS.
"To imagine that it's just like every other disease _ like cancer or diabetes _ is false," said Tracy Welsh, executive director of the HIV Law Project. "Getting a positive test result is something that turns somebody's life upside down."
"How will we ensure that those individuals who test positive will not be criminalized in an effort to contain the epidemic?" asked Ofelia Barrios, a staff member with the Harlem Directors Group, a consortium of AIDS services organizations.
Frieden said he was not proposing mandatory HIV testing or breaching confidentiality. But following his plan, he said, could halve the number of people "who find out that they're HIV positive when they're already sick with AIDS."
HIV testing policies differ around the nation. California does not require separate written consent for an HIV test, and the San Francisco Department of Public Health on May 16 amended city policy to eliminate the need for written consent there.