RECENTLY, President Obama announced the creation of Act Against AIDS, a five-year project designed to increase awareness of the burgeoning HIV epidemic in the United States. As we have become more skilled at treating HIV, public concern has waned, and there is a fear people will return to the risky behaviors that spread the disease. As more people learn to live with HIV, the number of victims of this disease rises, especially here in Rhode Island.

In studies on the spread of the disease, one truth has emerged: When people know their HIV status, they are much less likely to spread the disease. It is estimated that one in four Americans who are HIV-positive don’t know they have it. That works out to about 500 HIV-positive Rhode Islanders who are currently carrying and spreading the virus. More than half of new infections come from people who aren’t aware of their status. Increasing testing rates would not only stem the spread of disease, but help those who are HIV-positive, since they can expect to live a long and healthy life if they work closely with their physicians early on.

There is a problem with testing, however. The old paradigm of targeted testing of men who are IV drug users or have sex with men is not effective. This disease has now spread into the mainstream heterosexual culture. The vast majority of women with this disease, for example, get it through unprotected heterosexual consensual sex. This is why the Centers for Disease Control and Prevention recommends routine testing for all sexually active adults.

A tough decision now lies before our state government, and it centers on signatures. The legislature is considering a bill that would eliminate the requirement that a patient must sign his or her name to receive an HIV test, and would essentially make getting an HIV test more like getting any other medical test.

Opponents say the bill would lead to more people being tested against their will. The problem, though, is that people who need the test aren’t getting it. The evidence is overwhelming that eliminating the signature would decrease the burden of HIV in Rhode Island. It’s pretty simple. In clinics geared toward HIV, getting a signature is no problem. But what the HIV specialists in our state are encountering is patients coming in with late-onset disease who could have been tested at multiple times in the previous years but weren’t, because in hospitals, emergency rooms and primary-care offices getting the form and signature are bothersome, and an impediment to testing.

This delay makes all the difference. Fight the disease early, and one can expect to live well into old age. Fight the disease late and incur a grave risk of death. Delaying the diagnosis can mean AIDS. Knowledge of infection dramatically reduces the likelihood of its spread. When California removed the requirement for a signature, rates of testing skyrocketed. This law has now spread to most states, and most of Rhode Island has been left behind.

We say “most of Rhode Island,” because three years ago, our state passed a law that pregnant women should have testing that is signature-free. The state did so to increase testing rates, and decrease the number of babies with disease. It worked. Testing rates of pregnant women rose from 53 percent to 93 percent, and Rhode Island went from the sixth highest rate of babies with HIV to zero cases. There have been no babies born in Rhode Island with HIV in the past three years. Not only did this save children, it saved our state (and your tax burden) at least $5 million dollars in health-care expenditures. This simple change to the law works.

Last year, the General Assembly put off this bill for further consideration. Since then, about 150 new Rhode Islanders caught HIV. Many of those were women, and most of those women were not “high risk”; they didn’t use drugs and they had a normal number of consensual partners. There is more HIV in Rhode Island now than ever before, and we have to move to stop this horrible disease. We cannot afford to put this off another year. Clearly, the legislature must pass this bill.

Brian Alverson, M.D., is an assistant professor of pediatrics at the Brown Medical School and head of the Section of Pediatric Hospitalists at Hasbro Children’s Hospital.