NEW YORK – The American Civil Liberties Union is concerned that the CDC’s new HIV testing recommendations may harm the health of those newly diagnosed with HIV and compromise the civil rights of anyone seeking medical treatment.
“The CDC should be commended for trying to increase the number of people tested for HIV, but eliminating the only safeguards that guarantee that testing is voluntary and informed does little to ensure that people will receive the care they need,” said Rose Saxe, a staff attorney with the ACLU AIDS Project. “Studies have shown that patients who are tested without consent are less likely to get the follow-up care that is critical to maintaining good health.”
Under the previous guidelines, the CDC recommended that those being tested for HIV give written consent to be tested and receive both pre- and post-test counseling. The new recommendations eliminate both written consent and counseling.
Doing away with written consent requirements could easily lead to people being tested for HIV without their knowledge, particularly in urgent care settings where health care providers may not have the time to have a meaningful discussion with a patient about the consequences of HIV testing and what it means to have HIV.
“Receiving an HIV diagnosis is a significant life-changing event. In addition to having to learn to live with a life-threatening disease, people with HIV deal with the continuing stigma that comes with having HIV,” added Saxe. “Without pre- and post-test counseling requirements, we risk losing a critical opportunity to educate people about HIV and how to prevent the spread of it.”
The previous counseling recommendations sought to ensure that medical providers educated patients about HIV and how it is transmitted. Because certain vulnerable populations, such as HIV positive adolescents, are at even greater risk of self-destructive behavior without adequate counseling, the new recommendations could cause adverse results, jeopardizing the health of those newly diagnosed and hampering prevention efforts.
According to the ACLU, the new regulations also raise serious privacy concerns. Virtually every state in the nation now collects the names of those who test positive for HIV. Many states also require doctors to report private information, such as drug use and sexual history about those who test positive.
“HIV discrimination is still rampant in this country. People continue to lose their jobs and housing because they have HIV. If the government is going to invade people’s privacy by collecting the names and deeply personal information of people with HIV from their doctors, at a very minimum, people deserve to know that this information is being collected and how it is going to be used,” added Saxe. “Health care providers should also inform patients if anonymous testing is available, so that people can make an educated decision about where to get tested.”
In November 2003, the ACLU released a survey of HIV service providers finding that HIV discrimination is still persistent throughout the United States. A copy of the 2003 survey is available at: www.aclu.org/pdfs/hivaids/hiv_civilrights.pdf.
A copy of today's CDC recommendations on HIV testing is available at www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm.