Routine HIV Testing—Just Say Yes
The CDC is recommending that we change our approach to HIV testing.
Testing for the AIDS virus could become part of routine physical exams for adults and teens if doctors follow new U.S. guidelines expected to be issued by this summer.Federal health officials say they would like HIV testing to be as common as a cholesterol check….
One-quarter of the 1 million Americans with the AIDS virus don’t know they are infected, and that group is most responsible for HIV’s spread, CDC officials said.
I agree 100% with Georgia10 at DailyKos:
We cannot stop the AIDS epidemic with a rate of 24%-27% of undiagnosed carriers. Making AIDS testing as common as an ordinary blood test can go a long way to dealing with this health crisis.
If everyone who carried the virus knew his or her HIV status, it would significantly reduce the infection rate. It wouldn’t eliminate new infections, of course, but it would bring it way down. Not only would more people who are currently infected know that they had to take steps to protect their sex partners, routine HIV testing would also mean that more people who are infected would get treatment—and treatment seems to make HIV-positive people less infectious by reducing their viral load, which would further cut the infection rate. It would also lead to more, and more effective, sero-sorting, the practice of positives seeking out other positives as sex partners, and negatives seeking out negatives. Sero-sorting is credited with reducing the infection rate in San Francisco, of all places.
Wow! Routine testing for HIV would save lives—so naturally the AIDS establishment is opposed to the CDC’s sensible recommendation:
Some patients’ advocates have voiced concern that the recommendations do not include pre-test counseling and sufficient informed consent.
You can read GMHC’s take here, and San Francisco AIDS Foundation’s take here.
Perhaps the CDC’s proposal can be tweaked—who could object to more counseling?—but the primary reason AIDS orgs will oppose the new guidelines is that many do little more than encourage people to get tested and offer HIV tests. If HIV tests become a routine part of regular medical care—and it should—it will be harder for many HIV orgs to justify their expensive, ineffectual existences.
Please don’t listen to the AIDS orgs on this issue: It’s past time that we began treating HIV like other sexually transmitted diseases. That means routine testing, names reporting, and contact tracing—all routine public health measures that will save lives, particularly the lives of African American women.
In a side note: One of the problems with HIV prevention education in this country is the slogan “Be Safe—Get Tested,” which creates the impression that testing is safety. I know lots of gay men who regard regular testing as some sort of retroactive absolution for whatever unsafe or risky activities they participated in between tests.
The only problem I would have with it is how the insurance companies would react. Would they/could they dump you or jack up your policy if they see you are positive? How will employers react? Would they/could they dump you from their group policy if they find out you are positive?
Of course, if we were sensible and would just open medicare up to everyone, this wouldn't be an issue. I'm usually fairly retro in my sensibilities, but this 1940's way of insuring people just sucks.