Feds Want Routine HIV Testing For Americans

[ECH1969]

All Americans between the ages of 13 and 64 should be routinely tested for HIV to help catch infections earlier and stop the spread of the deadly virus, federal health recommendations announced Thursday say.

We know that many HIV infected people seek health care and they don't get tested. And many people are not diagnosed until late in the course of their illness, when they're already sick with HIV-related conditions," said Dr. Timothy Mastro, acting director of the CDC's division of HIV/AIDS prevention.

"By identifying people earlier through a screening program, we'll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others," he said.

The announcement was hailed by some HIV patient advocates and health policy experts. They said the guidelines could help end the stigma of HIV testing and lead to needed care for an estimated 250,000 Americans who don't yet know they have the disease.

http://www.wnbc.com/health/9902461/detail.html

[blogslut]

1. Are the Feds going to pay for it?

n/t

[Horse with no Name]

2. By identifying them earlier

Then insurance companies can purge them from the rolls BEFORE they are symptomatic.
Unfukkingreal.

[Lone_Star_Dem]

14. Call me a cynic, but I agree

It was my first thought when I read the article and I'm sticking by it. Our government has been in bed with the big money for too long to all of a sudden give a damn about our health.

[JackBeck]

16. While I see your point,

wouldn't this be a slam-dunk for big pharma, who also have their hands in the pockets of our politicians? Get people tested and get them on meds, big windfall for big pharma.

[Horse with no Name]

19. I don't think so

HIV medications are very expensive--no doubt.
But the complications of AIDS and ARC are astronomical. Every insurer will do their best not to cover the meds OR the medical bills. By pre-identifying asymptomatic people with HIV (which by the way--not everyone gets full blown AIDS), these people can be weeded out of the insurance pool and basically left to die.
I will believe this is altruistic if I see some money attached to this...for counseling, for medications, etc. However, I think it is just this administrations way to attach a scarlet letter to the chest of Americans who are ill.
Why don't they waste their time pre-screening every American for cancer?
Now there is a disease that kills many every day. There are blood tests, mammograms, and other diagnostic tests available to screen for the different types of cancers. Not everyone can afford these tests. Many cancers, which,IF they were caught early would mean the difference in life or death to many.
Why not screen for that?
Because CANCER is where big pharma makes their money. Not HIV. You won't see cures for cancer in our lifetime.
It is a cash cow.
But you will see better and more expensive treatments.

[JackBeck]

20. You are aware that the government provides benefits, outside of

insurance companies? Even if one does not have insurance, there's HASA, SSI, SSDI, PA, AHIP...My point, which goes along with the article, is that there are many people in this country who have HIV and are unaware of their status. By testing everyone, it seemed to me it would benefit the pharmaceutical companies since clients will be encouraged to go on HIV meds. What we've been seeing in the community is a move toward a medical model, where clients don't see their doctor for more than 5 minutes. It's become diagnosis, here are your meds, see me in 3 months. There are many people who are on HIV meds that don't need to be.

And, by the way, I know not everyone gets "full blown AIDS". I'm an HIV Health Literacy Educator. I would bet most people around here are unaware of what an AIDS diagnosis actually is and why it's done.

[StraightDope]

22. Let's see, IIRC...

A diagnosis of Acquired Immune Deficiency Syndrome is made whenever detectable white cell counts fall below 200 / nl. Or is it T-Cell counts? That's the limit of my memory, but I do know that once that stage is reached, all kinds of weird opportunistic fungal, viral, and bacterial infections that almost never take root in a healthy person. Let me know how far off the mark I am.

[JackBeck]

24. You've got the most popular one correct.

One of these things must occur for an AIDS diagnosis.

1) CD4/T-cells, which are a type of white blood cell, drop below 200
2) CD4/T-cell % drops below 14%
3) One or more Opportunistic Infections.

You're right about types of infections that may occur when T-Cells drop below 200. They can happen at any point, actually, which is why OI's constitute an AIDS diagnosis.

The two reasons for an AIDS diagnosis?

1)Tracking and....2) Benefits. Once someone has an AIDS diagnosis, they will always have that diagnosis. The media does a disgusting and irresponsible job of using the word "AIDS" to scare people. An AIDS diagnosis doesn't mean you are on death's doorstep. Any of those three things I listed above is treatable. You can get rid of an OI, get your t-cells above 200, and get your T-Cell % above 14%, but do you still have an AIDS diagnosis? Yes. Why? So that your benefits are not taken away from you.

[alarimer]

21. that would be a big problem with any sort of mandatory testing

It just smacks of Big Brother. You cannot trust the government or insurance companies not to abuse it. While I agree that people should know their HIV status, I shudder to think what happens when it is reported to the insurance company.

[sweetheart]

29. by identifying them earlier, they can be imprisoned

They realize that AIDS is just like any other biological attack,
and that it is a practice run for the real deal, and with the real
deal, a short term deadly pathogen, testing like this would be probably
forced.

[StraightDope]

31. That's a bit glum...

[babylonsister]

3. Yeah, right. Healthcare is a non-issue, there's no money anywhere

for anything, yet the feds want everyone tested? :eyes:

[StraightDope]

4. If I DID have HIV, I wouldn't want to know...

But then again, I'm not sexually active, so...

[TechBear_Seattle]

7. And so you would die a horrible death, taking who knows how many with you

You will not always be sexually inactive (I would hope) and anyway, the definition of "sex" is vague in most people's minds, as President Clinton and many polls have shown.

If you know, it can be treated before it becomes fatal, and you will be aware enough to take appropriate measures and make informed decisions when you do become sexually active. If you refuse to find out, and other people get sick because of your deliberate ignorance, then you are no different than any other terrorist or mass murderer, and should be treated under the law accordingly.

[StraightDope]

8. Yeah, well...

Sexually inactive means just that. NO SEX OF ANY KIND AT ALL!!! So, there goes your first point of contention. Second, I don't have health insurance, and it's likely that I never will, so rather than being aware that I had an incuarble disease about which I could do nothing, I'd rather fall back on the, "Ignorance is bliss" credo.

Quit jumping to conclusions, it makes one look foolish.

[blogslut]

9. So, you're willing

to risk the lives of others simply to appease yourself? Sex isn't the only way to spread the infection you know. What about health care workers that draw your blood? Are they SOL?

[StraightDope]

10. What part of "I don't have insurance"...

Don't you understand? No one will be drawing my blood at any point in THIS lifetime. No, that's not an exaggeration. I make $6.00 / hr. My one luxury is fast internet. I hae no phone, no cable, no car, no credit cards, no real estate, no assets aside from an exceedingly old computer that's probably worth a grand total of $50. Thus, I will not, under ANY cirucmstances be visiting a health care facility for any reason. I can't afford it, and I won't become indebted for such frivolties as "checkups". Incidentally, I wouldn't want to know if I had ANY serious medical condition, transmissable or not.

Oh, and for what it's worth, HIV is destroyed when it comes into contact with oxygen, so there goes that argument.

[blogslut]

12. Giving blood is free

Guess you won't be doing that either.

As for the oxygen thing...well, I know my nurse friends always freaked out when they got stuck with a needle from an HIV positive patient. I guess they were just crazy lunatics.

[StraightDope]

15. Yes, if you're stuck with a needle, the nearly anaerobic environment...

Inside the hollow of the needle prevents viral oxidation, and the penetration of skin provides a route for introduction of infection. So, no, your nurse friends are 100% justified in their anxiety.

And no, I won't be giving blood anytime soon. Good cause or no, I HATE needles!

[JackBeck]

11. Depending on your income, you can qualify for benefits.

And most drug companies have drug assistance programs, called ADAP, which greatly reduce the cost of HIV meds. And if you have an AIDS diagnosis, a whole slew of government benefits are allotted, not to mention each state has their own set.

And you don't have to be sexually active to transmit HIV. A mother can transmit HIV to her child through breast milk. What happens if you donate HIV+ blood or donate your organs? There have been cases of HIV tainted blood getting into the system. Granted, the number of cases have been greatly reduced since the 80's, but one cannot forget human error.

[StraightDope]

17. Don't take this the wrong way, but...

I don't believe in using public assistance for my own personal benefit. Those monies are there for those who genuinely need them, and in my estimation, there are those who are in much more need than I. I might not have much, but I have food to eat and roof over my head. Social assistance programs should benefit those who are worse off than I, particularly families with children. Also, my religious beliefs prohibit organ donation or receiving transplants, and as for blood donation, I HATE NEEDLES. You couldn't pay me enough to voluntarily be stuck.

[sandnsea]

23. I hear you completely

100% It's why I haven't been to a doctor in ten years. On the other hand, a $50 blood test showed that I'm hypothyroid which can be fixed with a $20 medication. I was literally dying because I thought like you do, and didn't even consider very affordable treatments for minor illnesses that can kill too. Do try to get a basic blood screen every few years, mmkay? :hug:

[TechBear_Seattle]

25. Sex isn't the point. Insurance is irrelevant. Ignorance is NOT bliss

As others have already pointed out, sex isn't the only means of getting or transmitting HIV.

While someone who is not sexually active at the moment doesn't need to be tested every couple of months, it is still something you should do at least once a year. Also, I don't expect that you will be inactive for the rest of your life (at least, I certainly hope you don't deny yourself that kind of closeness and pleasure); when you do resume sexual activity, you really should get tested regularly every three months regardless of genders or what you and your parter(s) do together.

As for insurance: you probably don't want to get tested by a regular physician anyway (a record of regular testing can and has led to discrimination by insurance companies.) In most cities, there are clinics that will provide testing that is as anonymous as state laws will allow, either for free or on a sliding scale. The health departments of many rural counties offer similar services. In terms of economics and privacy, there is no excuse not to get tested.

While there is no cure for HIV, there are a number of treatments available. Federal programs exist (for the moment, despite the best efforts of the Talibangelicals in Congress) to cover most, if not all, of those treatments. Likewise, HIV care is covered by state Medicaid programs, and there is often local assistance, both government and private, to help defray medical and non-medical costs. As long as HIV disease is being treated, you can continue to work and have an active life.

Let me explain why this is a big issue for me. I came out as gay in the early 80s, when HIV was first coming to national attention. Many of my first gay friends and mentors ended up dying from it. Between 1984 and 1990, I attended 17 funerals for friends who had died from HIV, with eight in 1986 alone. In the last 20 years, I have done volunteer work in hospices; I know exactly how advanced HIV infection ravages the body and mind. And right now, one of my cousins is living strong despite her having HIV: she got it ten years ago from an ex (now late) boyfriend who never told her about his heroin habit. Because she was getting tested regularly, she was able to start a course of treatment that has kept her alive and reasonably healthy, and which will let her see her grandson graduate high school, despite working as a file clerk at slightly above California's minimum wage at a company that does not offer insurance.

All this has moved me to be a safer sex educator, an advocate who has spoken to county health boards on the need for free, anonymous testing, even a laboratory test subject in stage 1 trials for an HIV vaccine. (Stage 1 means that it was the first time the vaccine was tested on humans. I found out after the trial that I was in the group to get the actual vaccine and not the placebo.) While the vaccine wasn't successful to go on to stage 2 tests, it did point to other avenues of research that have led and will continue to lead to a vaccine, perhaps even a cure.

HIV is a horrific way to die. As your immune system collapses, you end up with half a dozen different types of cancer dissolving your internal organs, leaving you too weak to sit up and too nauseous to eat. Fungi can start choking off your vocal cords, leaving you unable to speak. Bacteria fill your lungs with thick fluid. Viruses chew up your brain and leave big, gaping holes that impare your ability to think, to dream, to communicate, to remember a time when you were strong and whole. You end up a mindless 80 pound skeleton in a bag of rotting skin. It is a kind of death that I would not wish on anyone, not even Bill O`Rielly or Rush Limbaugh. Certainly not on fellow DUers.

With regards to HIV, ignorance is NOT bliss: it is a death sentence. If you are not aware that you have HIV, you can not treat it, and early identification and treatment is the only way to fight the disease successfully. A person who does not begin treatment until they are symptomatic has about one quarter the chance of survival as someone who is diagnosed while they are asymptomatic.

While you are totally and completely not sexually active, you don't need to worry about practicing safer sex. If that ever changes, though, or if you are ever in a situation where you might contract HIV (get stuck with a syringe needle, exposure to medical waste, blood transfusion, etc.) PLEASE don't make excuses for not getting tested, as there are no excuses. Please.

[JackBeck]

26. Thank you for sharing your person story and advice.

I'm an HIV Health Educator. While we don't teach prevention, we help educate those who are HIV positive, hopefully increasing their health literacy. Can you believe, 25 years later, we still encounter people who think HIV is airborne?

[TechBear_Seattle]

27. I know people who think there is a cure, so no need to act responsibly

Treatment that works for about 80% of persons with HIV does NOT translate into a cure, no matter how much wishful thinking or "I'm young; I'll live forever" mentality you might summon. Which gets back to my original point: the only way to treat the disease and keep from spreading it to others is to get tested regularly and then act responsibly and honestly if you turn up positive. With testing available at low to no cost, with treatment options available regardless of medical insurance, it is the height of irresponsibility not to get tested, to yourself, to your family and friends, and certainly to your partners.

[StraightDope]

28. That is a most heartwrenching story...

And I am sorry for the losses and heartache that you have had to suffer over the years.

In my case, much of your advice doesn't apply as it would to a "normal" person. Allow me to explain:

"Also, I don't expect that you will be inactive for the rest of your life (at least, I certainly hope you don't deny yourself that kind of closeness and pleasure); when you do resume sexual activity..."

I'm a virgin in my late 20's, heterosexual, and I will almost certainly remain a virgin until my death. I've never even kissed another person, let alone participate in anything more racy. I don't work in the medical field, I'm not a drug user, I don't engage in any other high-risk behaviors, etc. I see no good reason to subject myself to a period of days-long mental anguish every few months or year or so.

Incidentally, if I were to receive a positive diagnosis, I'd spare myself the ravages of horrific complications that you so graphically describe, and just put a bullet in my head, and be done with it.

In any case, thank you VERY much for your tireless efforts to fight this plague, and educate those who are most at risk. I didn't mean to sound callous about this situation, and if I offended you, I'm sorry, it's just that for ME, I see no need to be tested in the first place. If my situation ever changes, I'll be the first one in line to get tested, I promise you, but I won't be holdig my breath.

[Liberal Veteran]

32. Hear! Hear! I can speak from experience on that.

When I got tested after finding out my partner was cheating on me, way back in the old days when there was so little info, I got tested before seroconverting and thought I had dodged a bullet.

I was extremely careful after that and never had unprotected sex again. A good 14 years later I found myself diagnosed with advanced HIV-Disease (what they used to refer to as "full-blown AIDS").

That was 3 years AFTER triple antiretroviral therapy became the standard, but to make a long story short, by the time I found out I had AIDS, my immune system was completely shot to the point of being damn near non-existant (22 t-cells is NOT a good number). It took me almost 3 years to climb up to a level of immune function that put me at low risk for opportunistic infections (that number is 200 t-cells). As it stands now, my t-cells are steady at around 350 (a healthy person has 500-1000 per ml).

If I had started therapy a couple of years earlier, I'd probably have not gotten sick to begin with and I wouldn't have had to face a long climb back to a semblance of health, nor would I have had to put myself through a years worth of interleukin-2 therapy to get my tcell count over 200 (which involved injecting myself with a substance for a week every 8 weeks that has some of the nastiest side-effects you can imagine including extreme fatigue, fever, nausea, muscle aches, etc...basically like the worst flu ever).

The notion that ignorance is bliss is bullshit and deadly. 6 years ago, I was pretty close to being another AIDS death. As it stands now, thanks to treatment I still work full-time and haven't been sick at all (other than the side-effects from an admittedly off-label usage of a chemotherapy drug to boost my t-cells as mentioned above).

If routine testing keeps people from finding out way too late that they have HIV, then I am for it. I see it as no different than tests to see if you have heart disease or diabetes.

[OneBlueSky]

5. this is insane . . . just another money grab by the health care industry

and a way to weed out "unacceptable" insurance risks early on . . .

[TechBear_Seattle]

6. I strongly support routine testing. But...

Only if it is anonymous testing. But of course, the Junta isn't looking to protect national health (if they were, why do they continue to cut health services?) They want only to identify and stigmatize those they deem to be "socially undesireable," and anonymous HIV testing certainly does not fit in with that agenda.

[JackBeck]

13. I agree. Most people are unaware of the different types of testing.

If it's not anonymous testing, my fear is the creation of lists and websites where you can check a person's status, thus increasing the stigma even more for those who are HIV+.

[TechBear_Seattle]

18. My MD strongly *discourages* patients from being tested by him

For just that reason. Instead, he recommends that they go to one of the several clinics in Seattle that do HIV testing. This way, insurance companies will never see that a person is being routinely tested and can't discriminate on that basis.

[SydBinFL]

30. As the number of people with HIV/AIDS rises, funding for services drops

http://www.sun-sentinel.com/news/local/broward/sfl-rxbhiv21sep21,0,3341501.story?coll=sfla-news-broward

[JackBeck]

33. It's not just in Florida.

Welcome to DU, SydBinFL!

The non-profit agency I work for in NYC lost over $300,000 from Ryan White Care Act. From what I've been hearing, the RWCA is supposed to be renewed this year, but the monies are going to be distributed the same way the Homeland Security monies were dispersed, meaning the places that really need the money will be getting less.