Massachusetts Resists Implementing CDC Recommendation To Waive Written Consent Requirement For HIV Tests

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HIV Tests

Massachusetts is "resisting a year-old push by federal health authorities" to implement CDC's recommendations to waive a written consent requirement for HIV tests and make the testsa routine part of medical care for people ages 13 to 64, the Boston Globe reports. According to the Globe, Massachusetts is one of 10 states that require written consent for HIV tests.

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Healthofficials in Massachusetts say they share CDC's goal of making HIVtesting more routine. Officials also say that they believe they canincrease testing rates and still require written consent by conductingan additional 11,300 tests in health and family planning clinics andsubstance abuse treatment facilities over the next two years. Under theRyan White Program reauthorization,the state could receive less federal funds if new HIV cases arediagnosed more slowly than in states that implement CDC's guidelines,although the amount is unclear. Massachusetts currently receives $19.5million annually under the program, the Globe reports. About 12 states have passed laws in an effort to implement the CDC guidelines, according to the Globe.

Accordingto some state officials and HIV/AIDS advocates, stigma associated withHIV is still widespread, and written consent and pretest counselingshould continue to be required. Massachusetts Public HealthCommissioner John Auerbach said many health officials are concernedthat people at high risk for HIV will avoid medical care if an HIV testcould be conducted without their consent. Auerbach added that he mightconsider changing his position if waiving the written consentrequirement would save the state money.

The debate overwritten consent for HIV tests has "exposed a deeper divide" aboutwhether HIV/AIDS should "continue to be regarded as somethingexceptional, with policies, resources and attention distinct from otherconditions," the Globe reports. B. Dale Magee, president of the Massachusetts Medical Society,said the society "want[s] the state to treat HIV like othercommunicable diseases." Magee added that written consent is notrequired for tests for tuberculosis, gonorrhea or syphilis.

TheCDC guidelines state that testing should be voluntary and that patientsshould be told they are receiving an HIV test. According to Ben Klein,director of the AIDS Law Project at Gay & Lesbian Advocates & Defenders,the guidelines do not address the realities of medical care. "Fordoctors who are overworked and in busy health care settings ... there'sgoing to barely be a discussion," he said, adding, "What has beenreally important about written consent is it's really not about thetesting process alone. It's the beginning of a process and arelationship between the doctor and the patient that goes beyondtesting" (Smith, Boston Globe, 9/1).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . TheKaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service ofThe Henry J. Kaiser Family Foundation.

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