San Francisco Chronicle - Friday, June 8, 2007
Patty Berg, Anmol S. Mahal, Michael Weinstein*

Research shows that people who know their HIV status are two-thirds less likely to spread the virus to other people (as reported by the Centers for Disease Control and Prevention). These Californians are not getting treatment that can prevent the onset of AIDS and hence dramatically extend their lives. Life expectancy for a person with HIV has quadrupled in the last 15 years, according to a recent study from Cornell University.

Too many people are still learning of their HIV status when they show up sick at a doctor's office or emergency room. Earlier this year, the San Francisco Department Public Health found that 39 percent of test subjects learned that they were HIV positive less than a year before being diagnosed with AIDS, thereby missing the opportunity for successful early treatment. After years of treating HIV differently than other fatal diseases, we need a cultural shift to ensure that HIV screening becomes routine. We all know that intervention saves lives. Medical providers should encourage HIV screening for every patient, but first, we must remove barriers to HIV screening.

Current law requires a patient to give written informed consent for an HIV test, the only diagnostic test that must meet this high standard. Many people are reluctant to be tested when they have to sign a permission form (testing by San Francisco Department of Public Health increased by one-third after the department stopped requiring a signature). Many medical providers are reluctant to bring up HIV testing because the informed consent standard is too high of a legal standard for a diagnostic test. Informed consent is designed to fully inform a patient about medical risks associated with surgeries and other medical procedures; but there are no medical risks to a test.

To ensure more Californians receive treatment for HIV and AIDS, and thus help stem the spread of HIV, Assembly members Patty Berg, Bonnie Garcia and Jared Huffman have authored AB682, legislation that removes these barriers to testing while retaining the fundamental voluntary nature of HIV testing. The measure changes informed consent to simple consent, just like screening for breast cancer and prostate cancer. At the same time, the bill requires the medical provider to advise the patient that he or she has the right to decline the test.

This week, the state Assembly unanimously passed AB682. We urge the Senate and governor to act swiftly to make this bill law.

Critics claim this bill exposes people with HIV to discrimination. It does not. California HIV anti-discrimination law is the best in the nation. The law protects all persons with HIV, from those who are disabled by HIV to those who may become disabled someday. California has an extraordinary record of protecting the confidentiality of people with HIV/AIDS. In the last 26 years of the epidemic, there has never been a public breach of confidentiality. And last year, California's confidentiality law was strengthened by increasing penalties for illegal disclosure of HIV test results.

California HIV policy has always protected the rights of the person, and AB682 ensures that "routine" screening is not "mandatory" testing. The test is never conducted without the patient's knowledge. In fact, routine testing is never done against the patient's will.

California law must be changed so more Californians get an early diagnosis and treatment through routine testing. AB682 is about early detection and preventing Californians from needless deaths from AIDS.

*(Assembly member Patty Berg, a Democrat, represents the First Assembly District; Dr. Anmol S. Mahal is president of the California Medical Association; and Michael Weinstein is president of the AIDS Healthcare Foundation.)
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