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New York Proposes Controversial Measures to Slow the Spread of AIDS
 
 
  NY Times
By ANDREW JACOBS
May 24, 2005
 
A commission appointed by the city's health department has proposed a set of measures to increase condom distribution vastly in prisons, schools and nightclubs, expand needle exchange for intravenous drug users and make H.I.V. testing a routine part of every emergency room visit.
 
The draft report, issued by the New York City Commission on H.I.V./AIDS, also calls on the city to pay for public awareness campaigns that would address crystal meth abuse among gay men, the strong stigma that AIDS has among African-Americans and the role that people infected with H.I.V. can play in stopping the spread of the virus.
 
"This report outlines the direction we need to take if we want to halt the epidemic," said Ana Oliveira, the executive director of Gay Men's Health Crisis and one of the commission's members. "The proof of the pudding, however, will be in the implementation."
 
Although dollar figures do not accompany its recommendations, many of the commission members said the report, if adopted in its current form, would transform the way the city deals with H.I.V. and AIDS. The panel, whose 21 members included doctors, researchers and advocates for people with AIDS, also calls for increased access to treatment and housing for people with H.I.V. and AIDS.
 
Dr. Thomas R. Frieden, New York City's health commissioner, said he was pleased by the proposed recommendations, calling them "a blunt assessment of where we are and a message of optimism."
 
If financed and put into effect, the proposals would drastically reduce the spread of H.I.V., he said, and "make New York City a national and global model of how to stop the epidemic." The report will be formally adopted on June 13 after a public comment period.
 
The report, 18 months in the making, comes at a time of renewed urgency among public health officials, who say the fight against AIDS has been losing steam even as infection rates remain steady. The growing apathy, they say, may be partly responsible for the appearance of a rare and possibly virulent strain of H.I.V. that was reported last February by the city's health department.
 
Although additional cases of that strain have not been documented, panel members said they were concerned that more than 4,000 New Yorkers test positive for H.I.V. each year. More worrisome, they said, is that a quarter of them learn their status only when they are found to have full-blown AIDS.
 
The report's most potentially contentious proposals involve ways to increase H.I.V. testing, especially among minorities, the homeless and intravenous drug users. In addition to encouraging more people to get tested, the commission endorsed new state rules governing how data on H.I.V. and AIDS is gathered.
 
The regulations, which go into effect on a temporary basis next week, streamline H.I.V. testing consent forms and allow health officials to collect detailed information about a patient's viral load and whether he or she is showing resistance to AIDS medications. Several commission members privately said their willingness to embrace the changes had encouraged the state to adopt the new regulations.
 
But Tracy L. Welsh, executive director of the H.I.V. Law Project, said she was worried the new rules would chip away at long-established safeguards on the privacy of those infected with H.I.V. "My concern is that this sets the stage for government involvement in private medical decisions," said Ms. Welsh, who was not a commission member.
 
While they acknowledged public concerns over privacy, many of the panel's members said they felt the benefits outweighed the costs. "I'm tired of folks coming through our doors who test positive and who were infected years earlier," said Tokes Osubu, executive director of Gay Men of African Descent and one of the commission members. "Chances are, they may have been unknowingly infecting other people, and this is something we have to stop."
 
 
 
 
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