AFC Supports Efforts to Expand Voluntary HIV Testing

The AIDS Foundation of Chicago (AFC) strongly supports expanded voluntary HIV testing for everyone, and especially for individuals at highest risk of infection. Given persistent HIV stigma, AFC also supports strong patient protections, which are instrumental in gaining the trust of at-risk individuals for HIV education, testing, and treatment services.

In Fall 2006, the U.S. Centers for Disease Control and Prevention (CDC) released guidelines for routine HIV testing. AFC supports the CDC’s goal of expanding voluntary HIV testing in order to reach individuals unaware of their HIV-positive status—estimated at 10,000 individuals in Illinois.

AFC does not agree, however, with CDC’s proposition that there is just one way (opt-out HIV testing with no written, informed consent) to expand the offer and acceptance of voluntary HIV testing. Diverse communities and settings need multiple and tailored approaches to meet their specific needs as well as strong patient protections and vital education.

Illinois can vastly expand voluntary HIV testing AND preserve patient protections: Written, informed consent is not a barrier to HIV testing. Illinois doctors already successfully counsel and test more than 99.99% of pregnant women and newborns (more than 180,000) each year with patient education and rights protections. AFC is requesting $2 million in the FY08 state budget to expand HIV testing by assisting providers with training, technical assistance, and small grants to make HIV testing readily available.

AFC has a long track record championing responsible public policy to expand the offer and acceptance of voluntary HIV testing services without shortchanging patients’ medical decision-making and confidentiality rights. AFC is lending this expertise to several working groups exploring ways to help people living with undiagnosed HIV infection—estimated nationally to exceed 250,000 individuals—in accessing voluntary testing, treatment, education, and other essential services.

As a participant of the Federal AIDS Policy Partnership’s ad hoc working group on HIV testing, AFC has joined a series of discussions with chief CDC officials on the agency’s plans to implement its 2006 recommendations. In addition, AFC is participating in working groups convened by the American Academy of HIV Medicine, which is collecting additional input from stakeholders from various disciplines on implementation strategies. Closer to home, AFC joined the Illinois Department of Public Health for similar discussions regarding HIV testing expansion in Illinois.

AFC Associate Director David Ernesto Munar was one of only two openly HIV-positive individuals invited to present to more than 300 clinicians, policymakers, and advocates assembled in late 2006 for a two-day HIV testing summit organized by Drs. John Bartlett of Johns Hopkins University, Kenneth Mayer of Brown University, and colleagues. Munar also spoke last month at a congressional hearing on HIV testing expansion organized by Congresswoman Maxine Waters (D-CA) and The AIDS Institute.

STRATEGIES TO EXPAND TESTING:

Guide for Clinicians: HIV Testing and Illinois Law

Guide for Policymakers: Assisting Illinoisans with Undiagnosed HIV Infection

Guiding Principles:
15 Principles for Expanded HIV Testing

Preserve the Right to Written, Informed Consent

Community Analysis of CDC Recommendations (PPT)

FACTSHEETS—STATE LEGISLATION:

Expand Voluntary HIV Testing in Medical Settings

Improve HIV Testing for Pregnant Women

2007 State Session Report

REFERENCE MATERIALS:

Estimated HIV/AIDS Cases in Illinois

Hospital Assn. Emergency Department Testing Toolkit

NASTAD Emergency Department HIV Testing Primer

Rep. Waxman Requests Information on New HIV Testing Guidelines

Call to Action Power Point

Chicago Sun-Times Editorial

Chicago Tribune article

Chart – CDC & IL Laws & Regs

CDC Press Release

CDC Guidelines

Letter from CDC Director

CBO Statement

NAPWA Statement

ACLU Statement

Letter from Congressmen to CDC

U.S. Preventive Services Task Force Statement

FACTSHEETS FROM LAMBDA LEGAL & ACLU:

The Importance of Informed Consent

Dispelling Myths about CDC Guidelines

Why Stigma Matters in HIV Testing

A Summary of Need for Voluntary Testing