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Author Topic: UAB to begin routine HIV screening  (Read 9525 times)

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Offline AlanBama

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Re: UAB to begin routine HIV screening
« Reply #50 on: June 08, 2011, 03:15:53 PM »
I spoke with one of the case managers at Birmingham AIDS Outreach; her take on it seems to be this:

Perhaps routine ER testing will help the 'officials' (I assume she means State and Federal) see that there is definitely an increased NEED for funding for treatment.   We hope that they will respond to this increase in need appropriately.  (not a ver batim quote, but this was basically what she stated)

My concern, as someone who depends on the State for my meds, is that the bunch of Republicans we have running this state will not see anything related to HIV as a priority.   Perhaps they will prove me wrong.

 ???
"Remember my sentimental friend that a heart is not judged by how much you love, but by how much you are loved by others." - The Wizard of Oz

Offline Sweet_C

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Re: UAB to begin routine HIV screening
« Reply #51 on: June 09, 2011, 06:41:19 PM »
I agree with routine testing and it should be treated just like any other condition.  Yes it's true that many are not going to have access to treatment at the time they're tested, but at least they'll know they need to be looking for a way to get help and maybe get in line for assistance.  It's terrible to find out you have HIV, but the earlier you know you have it, the better off you will be.

I think the point about the need for informed consent is a valid concern, but I think that in this instance, the right to choose comes at too high of a cost.  I'd rather be alive and physically healthy with the pain of a stigma than stigma free and slowly dieing and infecting others. 


The right to choose is not an absolute one.  That's why we have to wear seat belts and pay for hospitals, fire and police with our tax dollars.  I think testing is just one of those small categories of things where there is just not a good enough reason for any person to choose not to do it. 

Also, I would think if you're bending over to backward to opt out of testing, then you are probably the person that needs to be tested the most. 
Tested positive on September 11, 2008

Offline richie

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Re: UAB to begin routine HIV screening
« Reply #52 on: June 09, 2011, 07:16:21 PM »
The one thing I don't get about this particular argument (I'm not picking on your Phil -- many of voiced it here and in past threads on this topic) is:

If these requirements can't get met and testing is not done (with consent or not), then we really don't alleviate the NEED for treatment and support -- we are simply avoiding the KNOWLEDGE of the NEED. 
I've always been confused as to why we say, in one breath, that we need to fight stigma of HIV, and in the other say that we need to provide extra special hurdles to it. 
We tell people that they should let the health care providers know about their status so that they can be properly treated, yet we put up barriers to those that don't know from finding out -- so they can't get proper treatment. 
It's a virus and if we keep treating it differently from all other viruses, then the general public will also continue to treat it differently.  There are damned few medical tests that require written consent -- I can't even think of another right now, although I'm sure there must be.

Anyway -- my point is that at some point in time, we all have to stop treating this virus in accordance with it's stigma -- else we will never lose that stigma.

Mike

Exactly.  If we had the attitude that HIV is no different than TB, the stigma would go away, people would get tested, yada yada yada.  Make anyone with HIV eligible for Medicare (hence those without insurance can get treatment) and we have an effective path to reducing or eliminating transmission.  Doctors test, without consent, for all sorts of things.  Hepatitis anyone?  VDRL anyone?   Syphillis anyone?   Low testoserone anyone?  They're tested without consent.  But the stigma of HIV requires consent before testing.  How dumb can we be.   HIV will continue to spread until we test, test, test, at every opportunity, and offer treatment immediately.  Give us Medicare if we are HIV+, which makes immediate treatment possible.  Lets go for the 96% reduction in transmission and get rid of HIV!

My two cents. 

Offline Miss Philicia

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Re: UAB to begin routine HIV screening
« Reply #53 on: June 09, 2011, 09:17:50 PM »
I agree with routine testing and it should be treated just like any other condition.  Yes it's true that many are not going to have access to treatment at the time they're tested, but at least they'll know they need to be looking for a way to get help and maybe get in line for assistance.  It's terrible to find out you have HIV, but the earlier you know you have it, the better off you will be.

I think the point about the need for informed consent is a valid concern, but I think that in this instance, the right to choose comes at too high of a cost.  I'd rather be alive and physically healthy with the pain of a stigma than stigma free and slowly dieing and infecting others. 


The right to choose is not an absolute one.  That's why we have to wear seat belts and pay for hospitals, fire and police with our tax dollars.  I think testing is just one of those small categories of things where there is just not a good enough reason for any person to choose not to do it. 

Also, I would think if you're bending over to backward to opt out of testing, then you are probably the person that needs to be tested the most. 

So then by this thinking shouldn't you be advocating forced testing en masse by the government for every single adult American?
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Offline bocker3

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Re: UAB to begin routine HIV screening
« Reply #54 on: June 09, 2011, 10:25:02 PM »
Exactly.  If we had the attitude that HIV is no different than TB, the stigma would go away, people would get tested, yada yada yada.  Make anyone with HIV eligible for Medicare (hence those without insurance can get treatment) and we have an effective path to reducing or eliminating transmission.  Doctors test, without consent, for all sorts of things.  Hepatitis anyone?  VDRL anyone?   Syphillis anyone?   Low testoserone anyone?  They're tested without consent.  But the stigma of HIV requires consent before testing.  How dumb can we be.   HIV will continue to spread until we test, test, test, at every opportunity, and offer treatment immediately.  Give us Medicare if we are HIV+, which makes immediate treatment possible.  Lets go for the 96% reduction in transmission and get rid of HIV!

My two cents.  

Let's not get carried away.  HIV most definitely IS different than TB.  TB can be spread by casual contact -- in fact, in many states it is legal to FORCE treatment compliance for TB.  WHY?  Public health -- walking around and hacking up TB filled sputum is not a great scenario.  
Most testing does require consent -- perhaps not written consent -- but one is rarely strapped down and forced to give up blood if they don't want to do so.  Of course, if you are unresponsive, you are likely to be tested for all sorts of stuff without any real consent on your part (hopefully, a family member is involved, but in an emergency, not even that.....).
Bottomline -- we do need to stop treating HIV differently if we expect the stigma to pass. There are a few "details" on how we do this -- but one good place to start is with those already tested positive.  We need to remember it is only a virus all the time -- not just when suits our needs.  

Mike

edited to add:   btw -- VDRL and Syphilis testing are the same thing!
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Offline richie

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Re: UAB to begin routine HIV screening
« Reply #55 on: June 09, 2011, 10:47:16 PM »
I think we're in agreement re stigma.  I'm just taking it a step farther, as otherwise I don't see an end to HIV.  We're in this 30+ years, and progress, but still more and more infections, little drop in spread.  Desperate times call for desperate measures? 

I just figure if the government (in the name of national security) can now tap our phones without consent (including all cellphone records), monitor emails, chats, etc. without even a judge's approval, and touch our junk if they want at the airport, taking our blood isn't that far off.  The republicans are already trying to force every woman who's pregnant to carry full-term, which means they control women's bodies.  What's a mere needle compared to that!?

Offline bocker3

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Re: UAB to begin routine HIV screening
« Reply #56 on: June 10, 2011, 07:35:12 AM »
I think we're in agreement re stigma.  I'm just taking it a step farther, as otherwise I don't see an end to HIV.  We're in this 30+ years, and progress, but still more and more infections, little drop in spread.  Desperate times call for desperate measures? 

I just figure if the government (in the name of national security) can now tap our phones without consent (including all cellphone records), monitor emails, chats, etc. without even a judge's approval, and touch our junk if they want at the airport, taking our blood isn't that far off.  The republicans are already trying to force every woman who's pregnant to carry full-term, which means they control women's bodies.  What's a mere needle compared to that!?

Honestly, I think you are reaching here.  Increased testing is very good idea -- FORCED testing is not. 
Taking our blood is indeed very, very different from the scenarios you are equating it with here.  If you don't want to be screened by airport security, don't fly.  If you don't want your email monitored, don't send any.  If you don't want your phone tapped, don't use one. Now -- I'm not saying that I agree with the gov't doing those things, but you do have ways to avoid them.  Everyone has blood, therefore no one could legally avoid mandatory testing.

Mike
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Offline poz91

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Re: UAB to begin routine HIV screening
« Reply #57 on: June 10, 2011, 10:32:41 AM »
I see everybody talking about patients' rights, but what about patients' needs?

There is a legitimate "need" to know whether a patient is HIV+ or not because it is often crucial information to have in regards to diagnosis, treatment, and aftercare.

It's no different than "needing" to know a patient's blood type, "needing" to know if the patient is allergic to certain medications, "needing" to know if a female patient is pregnant or not, etc.

Not knowing can equal death.

Now I suppose you could compromise here... test everyone who comes into the ER but require consent before informing the patient of the results.

Offline richie

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Re: UAB to begin routine HIV screening
« Reply #58 on: June 10, 2011, 12:34:26 PM »
Honestly, I think you are reaching here.  Increased testing is very good idea -- FORCED testing is not. 
Taking our blood is indeed very, very different from the scenarios you are equating it with here.  If you don't want to be screened by airport security, don't fly.  If you don't want your email monitored, don't send any.  If you don't want your phone tapped, don't use one. Now -- I'm not saying that I agree with the gov't doing those things, but you do have ways to avoid them.  Everyone has blood, therefore no one could legally avoid mandatory testing.

Mike

Yes, I agree that OF COURSE I'm reaching.  Most successful change in any field throughout history has come through radical change, radical thinking.  Ejecting the status quo from the argument.  "I think there is a world market for maybe five computers," probably erroneously attributed to Thomas Watson, head of IBM  Yeah, right.  Whoever said it was thinking status quo.

Yes, I'm reaching. 

Offline bocker3

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Re: UAB to begin routine HIV screening
« Reply #59 on: June 10, 2011, 04:18:27 PM »
Yes, I agree that OF COURSE I'm reaching.  Most successful change in any field throughout history has come through radical change, radical thinking.  Ejecting the status quo from the argument.  "I think there is a world market for maybe five computers," probably erroneously attributed to Thomas Watson, head of IBM  Yeah, right.  Whoever said it was thinking status quo.

Yes, I'm reaching. 

You have a better chance of getting where you want with ROUTINE testing -- not MANDATORY testing.  What you suggest isn't radical -- it's unconstitutional -- there is no compelling state interest in making HIV testing mandatory. 
BTW -- what is the penalty, in your radical change, for NOT getting tested?  Jail? a Fine?  Being confined and physically forced to give blood?

Mike
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Offline richie

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Re: UAB to begin routine HIV screening
« Reply #60 on: June 10, 2011, 06:49:48 PM »
Bocker --

Think about it.  There already ARE penalities if you infect someone and they go to the law.  You can be put in jail.  Just being HIV+ and spitting are now cause for prison.  So having sex while HIV+ is illegal in many States.  Even IF you disclose first, the partner can say you didn't.  You lose.   Is THAT constitutional? 

I'd suggest that there IS a compelling State interest.  Why is there a State interest to keep you from comitting suicide?  It's illegal, right?  So having a deadly virus (and passing it around) would seem to have the same State interest.  I don't see in the Constitution where it prevents mandatory blood testing.  I've read it several times now, and based on other searches/seizure precedents (airports, anyone?), there is no right like that.  It might be damned unprincipled to do it, but not unconstitutional as I read it. 

Offline bocker3

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Re: UAB to begin routine HIV screening
« Reply #61 on: June 10, 2011, 11:34:10 PM »
Bocker --

Think about it.  There already ARE penalities if you infect someone and they go to the law.  You can be put in jail.  Just being HIV+ and spitting are now cause for prison.  So having sex while HIV+ is illegal in many States.  Even IF you disclose first, the partner can say you didn't.  You lose.   Is THAT constitutional? 

I'd suggest that there IS a compelling State interest.  Why is there a State interest to keep you from comitting suicide?  It's illegal, right?  So having a deadly virus (and passing it around) would seem to have the same State interest.  I don't see in the Constitution where it prevents mandatory blood testing.  I've read it several times now, and based on other searches/seizure precedents (airports, anyone?), there is no right like that.  It might be damned unprincipled to do it, but not unconstitutional as I read it. 

Then have at it.  You clearly have your panties tied in a knot and aren't thinking rationally -- you are thinking emotionally.  If you want to stop HIV stigma, stop trying to treat it differently.  You simply will not see this country revert to strapping down and unwilling person to have their blood drawn to test for a disease that hits a tiny fraction of the population, and can't be spread casually.  If you could spread HIV as easily as TB, then there might be a state interest around protecting the public's health.  Right now, the public CAN protect itself from HIV -- it's called using a condom.  So mandatory testing simply will not happen -- that would be unconstitutional -- regardless of your take on the constitution.  I'd rather see your passion and energy put to trying and making HIV testing ROUTINE.  As for this debate, I'm done -- I've said all there is to say on my side.

Mike
Atripla - Started 12/05
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Offline ds4146

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Re: UAB to begin routine HIV screening
« Reply #62 on: June 11, 2011, 06:59:03 PM »
Perhaps I did not make myself clear and or do it in the proper fashion, and I am not sure this one will be any better. But no one, and I mean no one has the right to force testing on anyone, period. Perhaps it is better to know, maybe you will start treatment early, who knows but yourself? And only you should be making that decision, when you test, if you test, and to go one step further, if and when you seek treatment.  And honestly, it would be lovely if HIV/AIDS was as rosy as some paint it did not have such the stigma, that we could all sit down at the lunch room table at work or school and talk about me having AIDS much like you would if I had cancer. But that is not the way it is. So until the view changes, therapy is available to everyone, then I am completely against this. Consensual, conscious choice only.

Offline ds4146

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Re: UAB to begin routine HIV screening
« Reply #63 on: June 11, 2011, 07:03:42 PM »
However, I have to respond to this, because you have, once more, taken a line out of a much larger post to try and pick a fight.
Now let me address this. That was not my intent and if that was the way it was perceived by others, I apologize. However this post by you, when you had not involved yourself before, is much like calling the kettle black.

Offline bocker3

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Re: UAB to begin routine HIV screening
« Reply #64 on: June 12, 2011, 11:50:53 AM »
Now let me address this. That was not my intent and if that was the way it was perceived by others, I apologize. However this post by you, when you had not involved yourself before, is much like calling the kettle black.

Ah, yes -- nothing like a good ol' "I'm sorry, but................" post to drive my point home.

thanks,
Mike
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Offline next2u

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Re: UAB to begin routine HIV screening
« Reply #65 on: July 12, 2011, 01:12:28 AM »
http://www.poz.com/articles/Pennsylvania_Testing_Law_1_20760.shtml

July 11, 2011

Pennsylvania Eliminates Signed Consent for HIV Testing

A new Pennsylvania state law makes HIV testing a routine part of medical care, the Pocono Record reports. Patients no longer need to provide signed consent for testing, but they may refuse to be tested. Negative test results no longer need to be presented in person, but positive test results must still be delivered only when there's an opportunity for immediate face-to-face counseling.

~~ me likey.
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