Lift stigma from HIV screening

 Posted 10/8/2006 8:04 PM

For most of the 1980s, a diagnosis of AIDS was a virtual death sentence. People suspected of having the incurable disease were shunned, fired from jobs or driven from homes. Many avoided getting tested for fear that their status would be revealed.

OPPOSING VIEW: Don't remove safeguards

The progress since then has been remarkable. New medications keep the HIV virus in check so that patients who are diagnosed early can extend their lives by 25 years, according to a Harvard Medical School study. Public attitudes have softened.

But that progress has exposed a new problem — and opportunity. Far too often, the disease isn't discovered as quickly as it could be, endangering those people as well as others they might infect. As many as 1.2 million Americans are HIV-positive, and an additional 40,000 are infected each year.

Making HIV screening as routine as tests for high blood pressure would address the problem. New guidelines from the federal Centers for Disease Control and Prevention urge providers to offer regular, routine — but voluntary — testing for everyone 13 to 64.

The CDC also wants states to reconsider laws that deter testing. Some 31 states require specific informed consent, and 23 demand extensive pretest counseling. Those outdated laws were written for a time when little was known about AIDS.

Some civil liberties and AIDS advocacy groups worry that testing could become mandatory and compromise patient confidentiality, but that is a concern with all medical records and can be controlled.

The benefits of wider testing far outweigh the risks.

As many as 300,000 people with HIV don't know they have it. Their own health is in jeopardy, and they unwittingly transmit the disease to others. People who don't know they carry HIV account for up to 70% of new infections. When they do become aware of their status, they take steps to avoid infecting others — a two-thirds reduction in risky sexual behavior.

Further, the screening of all pregnant women, which started in 1995, decreased the number of children who contracted AIDS via their mothers from a peak of 945 in 1992 to 48 in 2004.

Because HIV can be diagnosed before symptoms develop, finding more infections gets patients into treatment faster, slows the spread of AIDS and saves lives. The widespread screening that so dramatically lowered the AIDS rate in babies can do the same for adults.