Should Every American Adult Be Tested for HIV?

[Roon]

July 12, 2006 — As an HIV prevention counselor, Sharlene Miles knows a thing or two about slowing the spread of HIV and AIDS.

Still, she was one of hundreds of Washington, D.C., residents waiting in line recently to get a free rapid HIV test. The attendees were there to help kick off Washington's new push to encourage doctors to routinely screen everyone between the ages of 14 and 84 for the virus that causes AIDS.

If this happens, it means that just about anybody over the age of 13 could be asked by their doctor, "Would you like an HIV test?"

Unlike the early days of the virus in the 1980s, HIV testing is today more accurate, and the disease itself can be treated as a chronic disease, meaning people can live a normal life span, said Dr. Michael Saag, the director of the University of Alabama's Center for AIDS Research in Birmi

http://abcnews.go.com/Health/story?id=2179090&page=1

[Cornus]

1. Only if the adult wants to be tested nm

[HiFructosePronSyrup]

2. Sure.

If they want to.

[WannaJumpMyScooter]

3. Ummm. No.

Nor should we be all given tests for far more dangerous and prevalant conditions.

Fucking idiots.

[TwentyFive]

4. What would 'they' do with the information?

Considering the current political climate, I would fear for anybody who tests positive.

[dsc]

5. I am not sure this is a wise use of money

Frankly AIDS cases are still conscentrated among high risk categories. Most people know if they are or aren't in such a category. For example, I haven't had any sex for quite some time and thus am at zero risk. Why should I spend money on an HIV test now? On the other hand if I get lucky then of course.

[TalkingDog]

6. Been tested twice thanks.

I'm one of those people that think responsible people who are going to have sex with someone they've never had sex with before should have a STD screen.

But that's just me.



My favorite Future Famous Dead Artist: KarenParker

[ayeshahaqqiqa]

18. My husband agrees with you

and had an AIDS test before we married. Since I was celebate before our marriage, there was no need to test me. But I appreciated his conscientiousness-HE thought of it and insisted upon it.

[serryjw]

30. That's very nice BUT

did he wait 6 months to have sex with you AFTER he had a 2nd test?

[xchrom]

7. no.

[benevolent dictator]

8. I'm all for available, free, *anonymous* testing

and I think that should be encouraged.

[KyndCulture]

9. no.

[pitohui]

10. no way

if we had guaranteed access to free health care including maintenance medications, i would say yes

however, what we actually have is that the person might never again be able to change jobs or do anything else that would involve a change of insurance because the person could no longer obtain new health insurance

if the person was young enough to not yet have a real career type job with health insurance, that person would likely never be able to pass a pre-employment health screening and get one, how then would they possibly pay for all these expensive HIV/AIDs maintenance medications?

the way the usa is set up, it is better for a person to find out later rather than sooner, so they have some chance of keeping their job/insurance due to seniority


after all, without the job/insurance, how do you pay for medicine that costs $10K a year just for the medicine -- let alone the doctors and tests?

a man at my husband's company got brain cancer in the early 80s and has been on medications for years, in some years the cost of treatment has been as high as $50K, he has never ever been able to even consider taking another job, no matter how much he might want to, because no other company offering health insurance would hire him

[Liberal Veteran]

15. I don't think that HIV screening is legal in the workplace.

As least not as a condition of hiring. HIV disease is covered as part of the ADA and an employee is not allowed to discriminate based on disability as long as the employee is able to perform the functions of a job with reasonable accomodation.

[pitohui]

20. that may be the law

but as a practical matter this employer surely wouldn't hire another employee w. a serious long-term illness

indeed, at one point, his insurer tried to pressure him to fire the guy w. brain cancer and even tho it isn't legal to fire him, the employer did do things to make him pretty miserable, such as taking away all of his responsibilities and reducing his pay

and he just has to take it, he can never go anywhere else

i guess i just don't trust "them"

the results of a test you never had can't be revealed to anyone on the job or in a lawsuit or by mistake

[Liberal Veteran]

24. Would you really want to work for a company that would do that?

I realize that's a loaded question, but I've been in the position of having to go hunting for a job knowing full well I had HIV. And quite honestly, the company I work for now had access to my prescription drug records because they managed my prescription drug program for the previous company I worked at while I was taking antivirals.

What we are talking about is getting an HIV test as part of routine medical care covered by HIPAA laws and confidentiality. I wouldn't expect a company I applied for to ask my doctor for my status if had heart disease or diabetes any other long term chronic condition any more than I would expect them to inquire about my HIV status.

There are a select few jobs that would be a condition for employment (I think surgeon is one of those jobs), but those are the exception rather than the rule.

[Erika]

11. Nanny, big government program, no way n/t

[Liberal Veteran]

12. As someone with the disease, I say yes.

I got burned by getting an HIV test in the time between infection and seroconversion (or I may have had a false negative, no way of really knowing, but I think the former rather than the latter).

By the time I was diagnosed, I had one foot in the grave and an immune system that was damaged to the point it will never be normal again (even after 6.5 years of successful antiviral therapy, my t-cells aren't in the danger zone, but well below normal).

Would you expect your doctor not to check your blood for high cholesterol, diabetes, or your blood pressure?

[readmoreoften]

14. No!

:cry: Be Well Liberal Vet! You're one of my fave DUers! I'm glad you're taking care of yourself!

[Liberal Veteran]

21. Oh, I'm doing fine. My HIV is under control.

I take my pills religiously (being slightly obsessive compulsive is a plus with that) and have missed maybe two doses in 6.5 years. My viral load has been undetectable since the first 3 months after diagnosis and I've NEVER been hospitalized (although at the time of diagnosis, I was extremely underweight, had pneumonia of the ambulatory kind, and a hideous case of esophageal candiasis which made swallowing painful). All in all, even though I think about it all the time, at least I was lucky enough to survive long enough to have all these wonderful treatment options available to me.

I've had it for 20 years now and I plan to live a very long and healthy life.

Thanks for kind words and concern, though.

The one thing I am glad of is that in that my lifepartner of 16 years is negative, but it could have easily been the other way and I wouldn't want anyone to have to live with the guilt of knowing they unwittingly infected someone they loved because they were too scared to get a simple test.

[ayeshahaqqiqa]

19. Again, it involves risk factors

I think adults who have remained celebate all their lives shouldn't have to be tested, unless they are nurses or other people who may have come into contact with contaminated needles, etc.

[LeftyMom]

13. Everybody should be offered one, with a discussion of thier risk factors,

if any. It would be a waste to test people who engaged in any behaviors that put them at risk since thier last test, but it should be offered at any routine medical appointment rather than people having to seek it out.

It's especially important for young people to be able to get screening without stigma or special arrangements, because otherwise they often do without and deal with worry and potentially spread disease when there's no need.

[ayeshahaqqiqa]

16. This is a quandry for me

because I don't like any sort of mandate on things like this. And I'd hate to have to pay for a test that I know will come back negative when that money could be used to help with other health issues. But it would be nice to encourage everyone who fits the behavorial profile for "at risk" to be tested.

[Liberal Veteran]

26. On the flip side of that equation, how many spouses...

...have been cheated on unknowingly? Assuming you are not at risk is probably not a wise course of action either.

I

[ayeshahaqqiqa]

27. I guess it depends upon your spouse n/t

[Liberal Veteran]

28. I'm sure there are people that have absolutely no worries or risk factors.

My take on it is that people who THINK they aren't at risk may very well be the last to know their spouse/partner is cheating and/or doing intravenous drugs.

Now, I'll be the first to admit I am jaded, but I've met more than one young, apparently healthy young woman who was completely faithful to their spouse and found out the hard way that their partner wasn't living up to the trust they place in him. And by the hard way, they were routinely tested as part of a pre-natal care and found out they were positive.

To me, saying "Well, I don't think I'm at risk", is akin to saying "Well, there's no history of breast cancer in my family, so why should I waste money on a mammogram at the age of 40?"

A 20 dollar HIV test that comes up positive can be a lot cheaper in the long run than living in ignorance and unwittingly infecting someone you care about (or even someone you don't really care that much about).

[Nicole]

31. You are correct, I was one of them

I had no reason to think I ever needed to be tested for HIV. I didn't use IV drugs nor did my spouse, neither of us had blood transfusions. Plus we were married in the 70's before HIV, back when penicillin would cure whatever ailed you.

I was married for 30+ years to my "best friend", my "soul mate", etc.. I would have laughed at you if you told me he had cheated on me and I should be tested. I would have been wrong. Thank God I wasn't deadly wrong.

[Avalux]

17. Not involuntarily. Let me explain why.

This disease has a unique stigma attached to it, unlike most other illnesses. Think about the history of the disease, and the questions that go along with it - how did you get it? What were you doing? The psychological component of getting a positive diagnosis can be devastating and there won't be a support system in place to deal with it. Also, the medications are terribly expensive, and even though this article touts HIV as a chronic disease, it can only be called that if a person gets the proper medical care and can afford the medication. Without antiretrovirals, HIV will ravage the body's immune system in a short amount of time.

I can't support involuntary testing. It has to be a personal choice - up to the individual to get tested when they are ready.

[SmokingJacket]

22. It should be offered to everyone.

As should lots of diagnostic tests, IMHO. However... I'd hate for insurance companies to get this info. Even a false positive, which aren't rare, could damage a person's ability to get health insurance in the future.

[moc]

23. No, and here's why. The false positive rate of the HIV screening

test is inversely proportional to the prevalence to the disease in the population being screened. (This is true of all screening tests, not just HIV.) Even if the accuracy of the screening has improved (as stated in the article), it will be less accurate in low risk, low prevalence populations. If you blanketly screen entire populations, you will have a higher number of false positives, resulting in expensive follow up testing (not to mention needless psychological distress).

I'd like to see the sensitivity/specificity data on the new screening tests before saying comprehensive screening is a good thing.

[Redstone]

25. Nothing wrong with asking. Only wrong if forced.

Redstone

[Nicole]

29. Yes, if they want to be tested

I went for testing when I found out my former spouse was cheating on me. It was at the suggestion of my family physician. Before he suggested testing I hadn't even considered it because I had so much other stuff on my mind at the time. Like murder. :mad:

I was glad my Dr. asked me if I wanted to be tested and immensely relieved at the results.

[cboy4]

32. uh, no.

If it's part of combined blood-work for a physical/check-up and the patient consents, fine.

Consent, being the key word.

[misternormal]

33. No... simply no... n/t

[omega minimo]

34. Instead, let's test everyone for IQ, BS and DIY

:evilgrin:

[Raine]

35. NO

absolutely not, that's a slippery slope. x(