Test law brings end of AIDS epidemic one step closer
If you don’t know your HIV status, you should.
Today, it’s easier than ever in Massachusetts to learn your status through your doctor thanks to a change in a state HIV testing law that goes into effect Thursday. This law, “An Act to Increase Routine Screening for HIV,” modernizes testing laws, replacing the need for written consent before a test can be administered with verbal consent. The law maintains all privacy protections for patients that were present.
With an estimated 26,000 to 28,000 people living with HIV/AIDS in Massachusetts, but approximately 21 percent of them unaware they are HIV positive, it’s clear we need expanded testing of state residents to end the epidemic. Statewide, about one-third of those who learn they are HIV positive are also diagnosed with AIDS within just two months of their diagnosis, which shows they may have been HIV positive for years without knowing it — and without their health care providers ever suggesting they get tested.
Increased testing will help get those who are HIV positive into care and treatment earlier and result in better health outcomes and lower health care treatment costs. Earlier testing will also help prevent the spread of infections since those who know their status and are in treatment are much less likely to transmit the virus to others.
Massachusetts has long been a national leader in the fight against AIDS. New diagnoses of HIV have declined by 54 percent since 1999, which will result in $2 billion savings in health care costs. At approximately 650 diagnoses annually, we are tantalizingly close to eliminating the spread of HIV in Massachusetts. A critical tool in this fight will be the ability to more easily test those who are most vulnerable to HIV infection, including people of color and gay and bisexual men.
Black residents make up just 6 percent of the state’s population, but 30 percent of those who are living with HIV/AIDS. Hispanics/Latinos make up 8 percent of the population but make up 25 percent of those living with HIV/AIDS. Forty-four percent of women living with HIV/AIDS in Massachusetts are black, and 28 percent are Hispanic/Latina. Meanwhile, male-to-male sex accounts for 40 percent of those recently diagnosed with HIV in Massachusetts, making it the most common way people in Massachusetts become HIV positive.
All that said, it is clear we can’t test our way out of the epidemic. In 2009, between June 27-29, 2009, AIDS Action Committee held five town hall-style meetings to solicit feedback from providers, patients and activists in Boston, Worcester, Springfield, Gloucester and Brockton around testing practice. We learned stigma around testing prevented some people from getting tested. We learned that some people vulnerable to infection fear losing health care insurance if they test HIV positive and so they have not been tested. We also learned that there is a profound lack of confidence in the confidentiality of HIV tests.
Now that the challenge of expanding HIV testing is behind us, we need to work with the medical and public health communities to find a way to reduce stigma. We also need to ensure that all relevant medical information is securely in the hands of physicians who need it. And as we continue to move toward universal electronic medical records, we need to find ways to address patient concerns about confidentiality and ensure their full participation in the process.
In the meantime, the single most important thing you can do to end the epidemic is to learn your HIV status.