Rhode Island news
Doctors seek change in HIV-testing law.
01:00 AM EDT on Thursday, June 19, 2008
PROVIDENCE — Among the dozens of groups that have flooded the hallways of the State House this week pleading for last-minute action on a mountain of bills are Rhode Island’s doctors.
Medical professionals are calling for passage of legislation that would waive the requirement for written consent when a doctor wants to perform an HIV/AIDS test.
It would still be illegal to test patients without their knowledge or consent, but the change would eliminate the tedious paperwork that doctors say can serve as a hurdle to early screenings.
“All us on front lines are seeing people who have not had HIV testing previously, so we’re finding HIV very late in the course of their disease,” said Dr. Nicole Alexander, an infectious-diseases doctor at Rhode Island Hospital. “This is something that could have been prevented if we could have eliminated the barriers.”
The bill has languished in committee, but doctors, including Alexander, hope House leaders will push it along before the Assembly adjourns, possibly as early as tomorrow.
Currently in Rhode Island, HIV rates are dramatically on the rise, particularly among heterosexual women, doctors here say. Based on national projections, they estimate there are about 500 people in this state who don’t know they have it.
“Those 500 people will cause more than half of the estimated 130 infections we will see next year,” Hasbro Children’s Hospital pediatrician and Brown medical school professor Dr. Brian Alverson wrote in a letter to the House Health, Education and Welfare Committee. “If these 500 people are tested, transmission rates will fall dramatically.”
By diagnosing patients earlier, Alexander said hospitals could also cut costs.
“Talk about a bill that would save money and save lives,” said its sponsor, Rep. Eileen S. Naughton, D-Warwick, in a brief interview this week.
But the Rhode Island Affiliate of the American Civil Liberties Union strongly opposes the plan, saying it would diminish the importance of pretest counseling.
“The bill is a complete rewrite of the [32-page] HIV statute and nobody has been able to adequately explain to us why all the changes were made, so it goes well beyond particular issues of increasing testing,” said Executive Director Steven Brown.
“The doctors are acting as if that piece of paper is such an incredible burden that they can’t give anybody tests,” Brown said. “Our position is that informed consent is a very important criterion, especially for this type of testing where the stigma and discrimination that flows from HIV remains really great.”
The medical community argues that the language in the bill preserves a necessary degree of counseling, while further improving the statute that was amended last year to include prenatal HIV testing in routine pregnancy care.
“As we watch[ed] Magic Johnson during these NBA finals, we know it is a disease that responsible patients can manage for a full and happy life,” Alverson said. “Everyone who is sexually active is at risk for the disease … the time has come to break down barriers to testing.”
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