July 4th, 2009

Progress on Consent for HIV Testing?

As I’ve noted here several times (some might say ad nauseum), I am convinced that Massachusetts’ arcane law requiring written informed consent prior to HIV testing is a barrier to more widespread screening — an opinion that is shared by virtually every clinician I’ve asked about this issue.

Last week, there was an announcement about progress (of sorts):

Clearing the way for HIV testing to become almost as routine as checking for cholesterol, state public health officials issued an advisory yesterday saying that the written consent required by law can be included in general permission forms patients sign for medical care.

Until now, Massachusetts doctors have typically given patients separate consent forms to authorize HIV testing, but yesterday’s directive makes clear that one form is sufficient, as long as the general consent form explicitly mentions HIV testing. Separate permission forms pose a barrier to testing for patients and healthcare providers alike, health officials said.

I’m of two minds about this.  On the one hand, we could simply do away with the law — something that most other states have already done, with Connecticut’s pending legislation providing a wonderfully common-sense approach on how to do this.

In addition, putting HIV in with the general consent for medical care seems both 1) kind of sneaky (does anyone actually read all that paperwork?) and 2) perpetuating HIV exceptionalism, since no other specific diseases are mentioned.

These concerns notwithstanding, I’m all for anything that makes it easier for people to find out their HIV status.  As noted in this article, 31% of people in MA find out they have HIV within 2 months of an AIDS diagnosis.

And that’s 31% too high.

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HIV Information: Author Paul Sax, M.D.

Paul E. Sax, MD

Contributing Editor

NEJM Journal Watch
Infectious Diseases

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