If things go the way I hope, Gov. Schwarzenegger will soon put his name to one of the most important policy changes in the fight against AIDS in decades.
And they said we had a do-nothing year.
My Assembly Bill 682 is the most significant policy change on HIV since the mid-1980s. It has the potential to change thousands of lives, and to prevent an untold number of HIV transmissions.
Its singular accomplishment? Make it easier to test for HIV.
The result will be earlier detection, better treatment outcomes and less spreading of the virus. That’s a huge payoff from a little bill that made it quietly through the Legislature with overwhelming bipartisan support.
AB 682 puts into law a bit of common sense about HIV testing: A test is a test is a test.
Right now, healthcare providers need you to fill out a form before they can test for the presence of the HIV virus. That’s different than the way we look for cancer markers, or signs of diabetes, or pulmonary malfunction. It’s a nuisance for the doctor, and a worrisome barrier for the patient. The immediate result, as you might imagine, is less testing for the HIV virus.
The bigger result of the current law is tens of thousands of people walking around with HIV, unaware of their need for early intervention, unaware of the risk they are taking with their own health and possibly the health of others.
The Centers for Disease Control estimate that about one million Americans are living with HIV, and nearly 250,000 of them don’t know it. The California Office of AIDS says that here in California as many as 40,000 people are unaware they have contracted the virus.
Many of these people don’t receive appropriate treatment until they come down with another illness. And an alarming number of people never learn they have HIV until they are within one year of a full-blown AIDS diagnosis.
AB 682 sweeps away the unneeded barrier of written consent in some settings, and informed consent in others. The law will still require that the patient agree to a test. No one would be forced to receive a test under this law. Instead, the bill makes California a leader in adopting recommendations from the Centers for Disease Control for normalizing HIV testing.
Routine HIV screening will save lives, just as routine breast cancer screenings, or cholesterol screenings. And by making it more common in the overall population, we send the message that while some groups may be more at risk than others, controlling HIV is in everyone’s interest. Routine HIV screening will help reduce a stigma about the test both in the medical community and among the general public.
Most importantly of all, of course, is the fact that normalizing HIV testing means more people will be tested, and fewer people will die. That’s no small thing. In fact, it’s a good sign that California is moving into the lead when it comes to public health. And that’s right where we should be.