Fight Brews Over Aids in Albany

A battle is heating up over how to expand access to HIV and AIDS testing, as lawmakers and health advocates disagree sharply over New York’s mandatory written consent law.Earlier this month, the New York State AIDS Advisory Council passed a resolution that recommends eliminating the requirement for individuals to give their written informed consent before testing, saying that verbal permission would encourage thousands of individuals to get tested.AIDS advocates and some elected officials said the written consent law, passed in the 1980s, protects patients’ medical rights and is the only way to guarantee that testing is informed and consensual.“Having a note in a file of an oral consent does not provide the assurance needed that the person has given voluntary informed consent,” the deputy executive director of the HIV Law Project, Cynthia Knox, said. “HIV is not like other diseases,” she said, noting that it should not be treated as such. “There is still a great stigma associated with it.”The resolution, passed October 11 on a 6 to 3 vote, takes into account public health concerns about HIV and AIDS cases that go undiagnosed.Nearly 100,000 New Yorkers are known to be living with the virus, according to data published in April by the city’s Department of Health and Mental Hygiene. During the first six months of 2006, there were 1,355 new diagnoses of HIV or AIDS in New York City, but thousands more may be infected, health officials said.The chairwoman of the AIDS Advisory Council, Sandra Ruiz Butter, said the need to encourage testing overrides many of the critics’ concerns. “We did hear from medical providers that because of the extensive requirements for the written consent, they are discouraged from making this a part of the regular medical care,” Ms. Butter, who is president of VIP Community Services, said.She argued that “taking away the requirement for written consent in no way relieves people of the requirements for confidentiality.”Standards for obtaining consent made headlines last year, when the Centers for Disease Control and Prevention revised its recommendations and said HIV and AIDS testing should become part of routine medical care in health care settings.At about the same time in New York City, the health commissioner, Dr. Thomas Frieden, proposed a system of affirmative consent via written or verbal permission. Several pieces of proposed legislation similarly addressed testing requirements in medical settings and laboratories.This time around, it is unclear what legislative impact the resolution carries.Created in 1983, the AIDS Advisory Council advises the state’s health commissioner, but a spokeswoman for the state Department of Health, Claire Pospisil, emphasized that the recent resolution was only a recommendation. “We haven’t taken a position on the resolution as yet,” she said.At least one lawmaker, state Senator Thomas Duane, a member of the advisory council, said he did not support the resolution.“I support increasing the number of people being tested, but I think the best way to do it is by mandatory offering,” Mr. Duane, who is HIV-positive, said. He argued that written consent is a mechanism that documents consent and counseling, and that such a process encourages health care providers to discuss HIV prevention with patients on a regular basis.Others opposing the resolution said it did not address issues such as reducing the stigma associated with testing and offering routine HIV counseling and testing.“One of the things that concerns me about the resolution is that it only focuses on a very narrow piece of what is the challenge around HIV testing,” the chief executive officer of the Gay Men’s Health Crisis, Marjorie Hill, said. Ms. Hill, who was recently appointed to the council, voted against the resolution.Still, council members said they worded the resolution carefully and attempted to incorporate various perspectives. “We’re exercising our best judgment on this issue, as well,” Ms. Butter said.“A large number of people in our city and our country don’t know their HIV status; therefore, they’re more likely to spread the disease and not get the care they need,” the dean of Columbia University’s Mailman School of Public Health, Dr. Allan Rosenfield, said.

Fight Brews Over Aids in Albany

Fight Brews Over Aids in Albany

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