Monday, May 08, 2006

Are Feds Forcing Compulsory HIV Testing For All Americans?

The Centers for Disease Control (CDC) plans to issue new guidelines this summer which will require testing for HIV as part of routine physical exams for adults and teens. The CDC claims that at least one million Americans are infected with the disease, but at least one-fourth are unaware that they are infected, who the CDC believes are largely to blame for the spread of the disease.

While the recommendations are voluntary, an AP report notes that most doctors and insurance companies rely on the guidelines for treatment. Under the proposed plan, patients would not be offered a specific consent form to sign for the HIV test as they are currently afforded; instead, the consent will be incorporated into the standard consent form.

In many states, a person who tests positive for HIV is automatically reported to the state's Department of Heath, by name, as is the case in Indiana. An HIV positive test outcome can result in making a patient uninsurable. HIV tests regularly produce false positive results.

The American Medical Association supports the new guidelines. The argument behind the new guidelines is that standardized testing will reduce the stigma as well as the transmission. A spokesman for the AMA notes that doctors will face some challenges in implementing the new guidelines, in particular, procedures for notifying the patient of a positive test result.

Many people at higher risk of being infected with HIV often turn to anonymous testing to avoid the reporting reqirements under the existing law. Many at-risk patients may avoid doctor's visits altogether if they believe they are going to be forced against their will to be tested for a disease that will negatively stigmatize them for life. A growing minority in the medical community actually dispute the cause, transmission and appropriate treatment for HIV/AIDS, but the health care industry's large financial stake in the status quo prevents research dollars from going to study viable alternative explanations for the disease.

When HIV/AIDS was first discovered back in the 1980s, there was quite a hysteria that swept the country about the epidemic proportions the disease would reach in a few short years. An extremist legislator in Illinois, Rep. Penny Pullen, managed to get legislation through the legislature and signed into law which required mandatory pre-marital HIV testing for all couples applying for a marriage license in Illinois. So many wedding couples fled across state lines to avoid the testing, county marriage license receipts plunged. A year later the legislature repealed the law with the backing of the Illinois Medical Society. It will be interesting to see what the public's reaction to universal HIV testing will be.


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Marla R. Stevens said...

Thanks Gary. And let's not forget what Indiana law allows in terms of invasive behavior by the state health authorities -- generated on the basis of anonymous reports, no less.