Make HIV testing routine

A telltale sign of the healthcare system’s failure to deal realistically with HIV/AIDS is that in Massachusetts, 31 percent of those testing positive for the virus become afflicted with full-blown AIDS within two months. This means that for years they have been unknowingly infected, missing out on treatment and likely infecting others.

That statistic would be similar in other states, which is why the US Centers for Disease Control and Prevention began a campaign in 2006 to make testing for HIV/AIDS much more routine. While drugs have made the disease more treatable, each year approximately 56,000 Americans become infected. More than 20 percent do not know they carry the virus. Stigmatizing those infected was and is a problem - and calls for utmost confidentiality of test results - but the availability of treatments and the need to prevent transmission of the virus thoroughly justify the CDC position.

To make testing more common in this state, the Department of Public Health advised healthcare providers last week that the written consent for testing required under state law could be part of a general permission form that patients sign for medical care, and not a separate document. In another move to smooth the consent process, copies of consent forms will no longer have to accompany test specimens to the lab.

Steps like these bring the state closer to a CDC recommendation that clinicians provide HIV screening on an opt-out basis. The opt-out provision is at the heart of a bill in the Legislature sponsored by state Senator Patricia Jehlen of Somerville. It would end the state’s requirement of written consent and instead have healthcare providers inform patients verbally that the test is planned but that they can decline it. The providers would also explain the treatment options for those who test positive for HIV and, for those who test negative, the need to continue to be routinely retested. The bill prohibits any disclosure of test results to anyone other than the patient without the patient’s written informed consent.

The Jehlen bill would help destigmatize HIV testing itself. Doctors and other healthcare providers often hesitate to offer the test to patients out of concern they will see the suggestion as a judgment about their lifestyle. Dr. Lauren Smith, medical director of DPH, put it this way: “Let’s think about this as with any other condition where we have an effective treatment.’’ More testing and more timely treatment will indeed make HIV more like any other condition.