Racial Disparities in HIV Care and Outcome: A Call for An Evidence-Based Response, The Center for HIV Law and Policy (2006)

Recent proposals to change HIV counseling and testing protocols rest on claims that current laws incorporating informed, written 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 evidence-based, i.e., 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.