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Make HIV testing normal and routine
 
 
  Boston Globe September 9, 2007
 
THIS COUNTRY'S halting effort to limit the spread of HIV-AIDS reached a turning point last year, when the US Centers for Disease Control and Prevention recommended that doctors and public health officials make testing for the disease more routine. The CDC specifically called for an end to rules requiring that individuals first give written consent before being tested.
 
Concerned that this could cause some high-risk persons not to seek medical care at all, the state's public health commissioner, John Auerbach, wants to maintain the written-consent rule. His concern is valid, but the downside risk seems greater - that the failure to make HIV testing an ordinary practice will keep too many infected persons in the dark about their condition.
 
In little more than a decade, HIV-AIDS has changed from an incurable affliction to one that can be successfully treated with drugs. It is still a stealth disease, though, in its early stages. One-quarter of all those infected do not know they are carrying the virus - and in many cases are transmitting it to others through unprotected sex or shared drug needles. This is a major factor in a sad statistic about AIDS: Each year in this country there are about 40,000 new infections.
 
More widespread testing combined with thorough counseling would get more of those afflicted into treatment early, when it can be most effective. Individuals whose disease is being treated have lower viral counts, so they are less likely to transmit the virus. People who learn they are infected might also change their sex and drug-use practices.
 
The CDC's goal is to put the HIV test in the same category as tests for tuberculosis, syphilis, gonorrhea, or high cholesterol - for which written consent is not required, though patients can opt out. The HIV test had been treated differently because of the stigma attached to AIDS and, until the mid-1990s, the lack of any treatment for it.
 
CDC points to the success of widespread testing among pregnant women, which has greatly reduced mother-infant transmission of the disease.
 
Auerbach very much favors making HIV testing more routine. He said, though, that the disease's stigma, while reduced, still exists. In an interview last week, he said he might reconsider his support for the written-consent rule if other states that dispense with it find that testing increases substantially and that individuals are not shunning medical care altogether.
 
Auerbach said Massachusetts has been a leader in testing for and treating AIDS, noting that by the end of the next 12 months 50 percent of all state-funded HIV tests will be the rapid kind, with results in just 20 minutes instead of several days. Quick-result testing ends the common problem of persons taking the delayed-result test and not returning for the result. But more testing across the board should be the state's goal, even if it means ending the written-consent rule.
 
 
 
 
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