These materials focus primarily on federal and state proposals related to the streamlining of the HIV testing process, from more patient-tailored pre-test and post-test counseling to the elimination of informed, documented consent. Resources in this section also include slide presentations and journal articles on the effectiveness of voluntary HIV counseling and testing approaches; the importance of voluntariness and autonomy in health care decisionmaking to marginalized populations, particularly people of color; and the role of HIV testing as a gateway to comprehensive HIV health care and support services.
Expanding the Availability and Acceptance of Voluntary HIV Testing: Fundamental Principles to Guide Implementation, The Center for HIV Law & Policy et al.
In response to the Center for Disease Control and Prevention's (CDC) push for expanded HIV testing without counseling, documented consent, or assurances of linkage to care, a group of HIV legal, medical, and service organizations endorsed these fundamental principles to guide the implementation of expanded voluntary testing for HIV. The fundamental principles emphasize that HIV testing must always be informed, voluntary, confidential, and supported by health care and other services, and that testing is always most effective when offered by someone trusted and trustworthy. The primary authors of the Principles are The Center for HIV Law and Policy, AIDS Foundation of Chicago, and Lambda Legal. Click here to download.
Racial Disparities in HIV Care and Outcome: A Call for An Evidence-Based Response, The Center for HIV Law and Policy
Proposals to change HIV counseling and testing protocols rest on claims that current laws incorporating informed, documented consent are interfering with the testing and treatment that would eliminate racial disparities, and so need to be "modernized." But available evidence strongly indicates that the proposed plan is unsupported and unsound, and that eliminating virtually all provider-patient communication and written proof of informed consent will not result in earlier, better, and sustained access to HIV treatment and medical care, or better outcomes for people of color in this country. This is so because (1) the plan is not based on demonstrable evidence that counseling, consent, and confidentiality procedures are in fact discouraging patient care; and (2) the evidence strongly suggests that in fact the proposals will worsen racial disparities in access to and initiation and maintenance of, appropriate and life-prolonging treatment. Fortunately, as this report makes clear, the evidence also shows that there are a number of initiatives that likely would make a significant dent in these disparities, and in HIV-related stigma, consequently saving and improving many thousands of lives.
Click here to download.
What is the Evidence that VCT Works? Dr. David Holtgrave, Johns Hopkins Bloomberg School of Public Health
This slide presentation, reviews evidence demonstrating that, even from an economic perspective, a multi-component, multi-level, evidence-based comprehensive national HIV prevention plan for the United States is most effective. Holtgrave reasons that such a plan must address not only individual risk behaviors but also structural issues such as homelessness, poverty, social capital and income equality. His review of the evidence demonstrates that targeted HIV counseling and testing has substantially more public health benefits than opt-out testing, at the same cost. Click here to download.
Talking About Principled Testing
Click here to listen to CHLP Executive Director Catherine Hanssens discuss principles testing at the AIDS 2008 conference.
THE FINE PRINT
Say What You Like, An HIV Diagnosis is Anything But "Routine"
by Joseph Sonnabend, M.D., CHLP Medical Resource Specialist, and
Ashley Burczak, CHLP Program and Development Associate
With little attention to the concern of patients and their advocates, the medical establishment has largely taken up the aggressive push of the 2006 CDC recommendations on HIV testing in clinical settings as a tool to eliminate informed consent to diagnosis and care. This is truly unfortunate, and contrary to patients’ best interests. The embrace of “opt-out” HIV testing, in which patients essentially are told they will be tested unless they object, is at odds with hard-won advances in physicians’ ethical requirements for dealing with patient interventions with potentially serious health implications. More
Thirty-Five Groups Join Comments Submitted to CDC on HIV Testing in Correctional Settings
In response to a CDC request for comments, 35 organizations endorsed a joint letter submitted to CDC regarding its draft implementation guidance for HIV testing expansion in correctional settings. The Center for HIV Law and Policy, Lambda Legal, and the AIDS Foundation of Chicago drafted the letter following consultation with individuals familiar with the healthcare and HIV/AIDS-related needs of incarcerated populations. More