Routine and Voluntar

By Joey Terrill
Public Policy Coordinator
AIDS Healthcare Foundation

Last month the state Assembly unanimously passed AB682 – Routine Testing. It is now moving  through the state Senate.

At the same time, the Los Angeles city council unanimously approved a resolution in support of  AB 682 while the West Hollywood city council voted to oppose it.
Estimates are that nearly 40,000 Californians have HIV and do not know it. Medical providers do not routinely screen them for HIV.  People don’t think they have a reason to be tested or they do not have access to preventive medical care. Many of these individuals are unknowingly exposing other people to HIV. The statistics continue to show the spread of HIV and the alarming disproportionate percentage of new cases in communities of color. 

Current law requires a patient to give written informed consent for an HIV test, the only diagnostic test that must meet this high standard. Individuals are reluctant to be tested when they have to sign a permission form (San Francisco Department of Public Health increased testing by one-third after the department stopped requiring a signature). While appropriate back in the 1980s (when there were no medical treatments for HIV), the informed consent standard has become a barrier to routine testing. 

Informed consent is designed to inform a patient about medical risks associated with surgeries and other medical procedures; but there are no medical risks to a test.

Earlier this year, studies in California found that 39 percent of test subjects learned that they were HIV positive less than a year before being diagnosed with AIDS, missing the opportunity for successful early treatment. We know that intervention saves lives. Medical providers should encourage HIV screening for every patient, but  barriers to HIV screening must be removed.

AB682 removes these barriers to testing while retaining the voluntary nature of HIV testing. It changes informed consent to simple consent, just like screening for breast cancer and prostate cancer. It also requires the medical provider to advise the patient that they have the right to decline the test.

Critics claim this bill exposes people with HIV to discrimination. It does not. California HIV anti-discrimination law is the best in the nation. In the 26 years of this epidemic, there has never been a public breach of confidentiality. And last year, California's confidentiality law was strengthened by increasing penalties for illegal disclosure of HIV test results. City council members should know this.