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Op-Ed in NY Times on HIV testing

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My feedback is brief. I'm glad your piece was published. It is glaringly apparent we cannot get too much information out nor too often regarding testing, its importance and its availability. It is, to me, the most powerful key to making a swift and significant impact on the continuing toll of infections.


Dear Peter,

I remember the devastating childhood disease called Polio in the 50's and being dragged screaming into the Veterans Hall for mandatory vaccinations.  There was no choice on whether or not to have that vaccination and the disease was virtually wiped out by the time I reached High School.

I produced a series of radio commercials for the State Department of Health, Hawaii (Diamondhead Clinic) in the late 80's.  Those spots were picked up on every station with the individual stations accepting half price of the non-profit rate so they could partner with the Department of Health in this important issue.  Within weeks, everyone knew (on all 9 islands that, "even Indiana Jones uses a condom."

I live in California, you live in New York.  Your state and mine are the trendsetters in opinion, fashion, music, film, and popular culture.  The other 50 states follow what is done in California and New York, we set the tone, the world watches us and life goes on.  Until I read your article, I would not have known HIV testing was not readily accessible in New York.  I sit on several committees, all related to HIV in California and more specifically Sonoma County and am privy to a lot of information.  One issue that has gotten my attention recently is talk of mandatory HIV testing in California and I believe that conversation began at the State Department of Health, Office of AIDS.  Our care and treatment infrastructure in California is about to be destroyed, after many successes in HIV care because of the proposed changes in the RWCA and proposed changes on how federal funding is allocated.

Over 90% of all people living with HIV and on retrovirals (in California's 9 Title I EMA's) are registering non-detectable viral loads.  Last year in Sonoma County, nine HIV positive women, client patients of the Center of HIV Prevention and Care and the Russian River Health Center, chose to start families.  This includes delivering HIV negative babies, being there to see those babies graduate from High School and dancing at those babies weddings.  Every new mother in this group delivered an HIV negative baby.  With continued care and treatment, those families can see their HIV negative children graduate from High School.

Another issue I find distrubing is the 2005 Epidemiology report of Sonoma County  In this report the data collected shows the high risk trending away from gay and bi-sexual men (who held the #1 position in high risk for 25 years) to women who report heterosexual contact, as being the highest risk.  Hispanic families are the second highest risk.  An article written by Katy Hillenmeyer in the Santa Rosa Press Democrat (a New York Times Company), called Sonoma County Renews Latino HIV Education can be found in my web site  This article can be found in the LATINO SERVICES section of the site.

There are 1.1 million persons living with HIV/AIDS in the United States and an estimated 40,000 new infections each year.  When I tested HIV positive in 1994, it was pointed out that over 60% of all gay men living in metropolitan areas in the U.S. are HIV positive, whether they know it or not.  I was interviewed at the Positive Resource Center in San Francisco about 4 years ago, the statement that 60% of all gay men living in metropolitan areas in the U.S. are HIV positive, whether they know it or not was used.  That figure held in check for almost 10 years but real progress is not being made.  I would have expected Senator Clinton to be on this issue.

These are the primary reasons I believe HIV testing should be mandatory from birth in every state, in Guam, Puerto Rico and the U.S. Virgin Islands.  Have the best day

Dear David NC and Iggy,

You have some valid concerns that were expressed during the beginning of the Names-based reporting measure during the recent months.  I have seen articles in the Chicago Sun Times, the New York Times, the L.A. Times and the Denver Post which reflect the concerns of thousands of people who wish to remain anonymous.

Forum member TOM H provided a Community Sign-on letter to Robert S. Jannsen MD, Director, HIV/AIDS Prevention, in the forums.  I have included a link to this letter on the front page of my web site  Have the best day

I live in a state with mandatory reporting as well ( TEXAS  )  yes there are anonymous clinics but a soon as you are treated by a Dr your name is reported....for that matter when you buy meds you become another official record , if you have employer insurance you can be sure someone at your place of employment knows your status , If you have any agency support ( state, federal or private ) then there is a record of your status ,   the only thing that is not done is that your status is not reported to those who could most use it , like EMT / emergency room crews ( who probably have more legitimate use  than most others)  so I don't see any current issue with widespread testing availability and in some cases mandatory testing.
 By and large when there is openess and acceptance as a "treatable disease" the "fear factor" goes away....

It's a good piece, good on you Peter for wrioting it and on the NY Times for running it.

Testing is becoming routine in the UK, it is recommended as a standard test on request for GPs now under many circumstances.  It is in most STI clinics a routine "opt out" test. Most A&E depts will do it for 18-65 yr olds without asking, in many circumstances, eg suspected meningitis, TB.

However,  it seems many people's heads have yet to catch up with the medicine.  Many people in the UK are still diagnosed with a CD4 under 200 (plus PCP, etc etc).  There is no culture of routine testing.

We don't do the named notification thing here.

- matt


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