Tuesday, September 12, 2006

Routine testing on its way?

Todays' CDC Prevention News included a clip from the Fort Wayne (IN) Journal-Gazette regarding the possibility of a recommendation for routine HIV testing in the U.S. The story was a nicely done "local take" on a national issue. I'm guessing that the CDC included this item in its news roundup because overall reporting on the issue is comparatively slim, and this story helps keep the issue floating about in the HIV community.

Even though the article includes a caveat from "CDC spokesperson" Tammy Nunnally that the policy is only under consideration, I fully expect that the next few months will bring it to reality. If so, we'll see something like a quasi-voluntary testing policy (you will be tested unless you refuse) that "offers" the test to every person between the ages of 16 and 60 (or thereabouts) when they enter the health care system. Presumably this would include private as well as public health elements of the system.

The reasons being offered for shifting to routine testing seem to boil down to two things: simplifying testing (by removing mandatory counseling components) and the hope that this policy will duplicate the success of routine testing for pregnant women in reducing new HIV infections. And, of course, the possibility of offering routine testing is assisted by the availability of new tests which provide results in a matter of minutes rather than the wait of two weeks needed in the past.

The results expected include an overall "social desensitization" to HIV testing. Right now, there is sufficient stigma associated with HIV testing, that many who are at risk do not get tested for fear of that stigma. Given that such tests are supposed to be confidential, that whole issue speaks ill of our health care system that it cannot be trusted to keep the mere fact of being tested for HIV confidential. If HIV testing becomes routine, perhaps there will be a concomitant effort to increase the sensitivity of health care providers, especially in the private sector, to handle the results more discreetly.

There is nothing in this proposal, however, that would help with "social desensitization" to an HIV diagnosis. We still remain a society that will judge a person for his/her health status before we are moved to compassion regarding that same health status.

No comments: