« ACTION ALERT: TELL CONGRESS TO LIFT NEX BAN! | Main | ACTION ALERT: TELL CONGRESS TO KEEP MORATORIUM ON ALL CMS REGULATIONS! »
June 6, 2008
NONCONSENSUAL
universal testing principles
 |
Offering HIV tests should be a part of every doctor's routine |
Advocates are working furiously to make sure that when the state Assembly health committee votes to overhaul Article 27-f this session that written informed consent and pre-and post-test counseling remain an integral part of HIV testing. Article 27-f is the HIV testing and consent law in New York that protects the confidentiality and privacy of anyone who has been tested for or exposed to HIV.
Two competing bills will be up for a vote on Tuesday, June 10—bill A.11461 created by the New York State Department of Health, and introduced by health committee chair Dick Gottfried, and bill A.4813, introduced by Assembly member Nettie Mayersohn.
Both bills concern advocates for a troubling lack of true consent, but Mayersohn's bill is particularly dangerous. It removes all consent to HIV testing and completely eliminates pre-and post-test counseling. This bill incorrectly assumes that many patients are specifically denying to be tested, when in actuality doctors do not routinely offer HIV tests to their patients. And by eliminating pre and post-test counseling this bill eliminates the important conversations that doctors need to have with their patients—both those who test positive and negative. "The paper is not the barrier," said Matthew Lesieur, director of federal affairs for the New York AIDS Coalition. "Evidence has shown that the numbers of people tested increases exponentially when everyone is offered a test."
Gottfried's bill doesn't explicitly force testing but it includes only an opt-out measure for declining, thus undermining actual consent. "Think about when you're ordering something on the internet and it says 'check this box if you don't want to be e-mailed,' but you don't even see that box. So before you know it, your inbox is filled with spam," said Housing Works director of New York City policy, terri smith-caronia. "That's what 'opt-out' means, and it's a sneaky way around true informed consent."
Hispanic AIDS Forum, New York AIDS Coalition, Centro Civico of Amsterdam Inc., Housing Works, New York Civil Liberties Union, Bronx AIDS Services, Community Healthcare Network, Institute for Family Health, Betances Health Center, Legal Action Center, HIV Law Project, Brooklyn United Community Coalition, Center for HIV Law and Policy, AIDS Council of Northeastern New York, AIDS Community Research Initiative of America (ACRIA), Citiwide Harm Reduction, Lambda Legal, St. Ann's Corner of Harm Reduction, Community HIV/AIDS Mobilization Project (CHAMP), Washington Heights Corner Project and Community Health Action have all signed on to a statement of principles that New York State must include in any HIV testing and consent law. To join these organizations and sign on to the principles outlined below, contact terri smith-caronia at smith-caronia@housingworks.org.
Statement of principles: Expanding access to voluntary HIV testing
The undersigned groups share the goal of expanding the availability of HIV testing and streamlining the testing process for providers. But expanding and streamlining testing cannot come at the expense of guaranteeing informed consent. In fact, ensuring that people understand what they are being tested for and what a positive test result means in terms of treatment availability, transmission prevention, and confidentiality and antidiscrimination protections is sound public health policy. When people understand the test and its implications, they are more likely to seek treatment and engage in efforts to reduce the spread of HIV.
We believe that:
1. Our goal is not testing for testing's sake. Getting more people tested should not be an end in itself, but rather, a way to reduce the overall number of cases of HIV transmission to connect HIV-infected people with lifesaving care;
2. Streamlining the HIV testing process does not require eliminating the protections that informed consent provides, and this is consistent with CDC recommendations;
3. Expanding access to testing for all New Yorkers can be done by making HIV-related testing a routine part of primary care;
4. It is critical that people freely choose to be tested for HIV and provide informed consent in writing prior to the test to indicate that testing is being done voluntarily;
5. Informed consent means that people affirmatively choose whether or not to be tested for HIV, not that they are given the option to decline to be tested;
6. People should be fully informed about the availability of anonymous testing, who will have access to the results of the test, how those results can be used and what legal protections exist to vindicate any resulting discrimination before they choose to be tested; and
7. Existing confidentiality protections that do not operate as a barrier to testing must be retained.
We can increase the number of New Yorkers who know their HIV status in a way that is compatible both with civil and human rights AND sound public health policy. Dismantling written informed consent laws and patient/provider protections is not the way to do it. For these reasons, the undersigned oppose A.4813/S.7529.