Mandatory HIV Testing, Legal Concerns

From Ann Hilton Fisher, Executive Director, AIDS Legal Council of Chicago… She responds to a request from the Chicago Tribune for comment.

“I am delighted to hear that the Tribune editorial board is looking at the new CDC guidelines for HIV testing and counseling.

As I told you, we at the AIDS Legal Council know perhaps better than any other group in the state that HIV is NOT a routine diagnosis analogous, as the CDC suggests, with a cholesterol check. Girls with high cholesterol are not told to use a separate bathroom from their classmates. Women with high cholesterol are not told they can’t get a tattoo. Men with high cholesterol are not told that they can no longer see their regular dentist. Amputee veterans with high cholesterol aren’t told that their doctor won’t debride their stumps. We have seen all these things with an HIV diagnosis. HIV is not a routine diagnosis. A consent to “routine” health care is not a substitute for informed consent to HIV testing.

Here are some additional sources of information.

1. The American Bar Association position–informed consent is key, HIV is not an ordinary diagnosis, makes the analogy to genetic testing.
“The risks and benefits of an HIV test…involve complex physical, emotional, social, and legal consequences, and thus cannot be encompassed by a general medical consent”.
Link here:

2. Statement of regional and national HIV organizations in response to the new guidelines. “We support the routine offer of HIV testing.” “We support CDC’s recommendation that HIV testing remain voluntary and free of coercion.” “We support innovative strategies to expedite counseling and informed written consent to HIV testing.” “We strongly oppose recommendations to eliminate pre-test counseling and written informed consent.”
link here:

3. There are lots of strategies out there that can increase the number of people tested without giving up written informed consent. The summary of some of these strategies was prepared by the AIDS Foundation of Chicago, and although it is still in draft form, I have been told I may share it with the press. ink here

4. Illinois knows how to increase counseling, offers of testing, and acceptance of HIV testing while still retaining written informed consent. In labor and delivery settings, the PRTI project increased HIV testing from 72% to 97.9% in less than 18 months.

Ann Hilton Fisher
Executive Director
AIDS Legal Council of Chicago

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