The government has recommended HIV tests as part of routine medical care, a change from their historical position. Bravo. We're 25 years into this thing, AIDS is a disease with existing but imperfect treatment options, and it is time we regularly treated it as such.
Not everyone agrees, however:
"Rose A. Saxe, a staff lawyer with the AIDS Project of the American Civil Liberties Union, said her group opposed the recommendation because it would remove the requirement for signed consent forms and pretest counseling. In settings like emergency rooms where doctors are strapped for time, Ms. Saxe said, 'we’re concerned that what the C.D.C. calls routine testing will become mandatory testing.'I think this type of testing should follow the model of blood work, which gets screened for lots of things (doctors in the audience, help me out with other examples of things blood is normally tested for). If I ran the world, someone who consents to blood work consents to the rest of the medical tests that would normally go with it (unless they specifically ask to opt out, I guess) What could a rational, intelligent, defensible position be for not knowing one's HIV status, especially in 2006? I don't sign a special consent to find out my cholesterol levels, and I see no need to do so for an AIDS test.
Patients, particularly teenagers, she said, 'will be tested without an opportunity for understanding the magnitude of having a positive result.'"
As for the idea of the need for deep, pretest counseling? Nonsense. What other diseases do we require this type of approach for? I go in for a check-up, and might wind up having a prostate exam. The doctor doesn't spend time with me beforehand to explain that - even if he feels something and even if it eventually turns out to be prostate cancer - in general prostate cancer grows very slowly, and if we catch it early there are a variety of courses of treatment available, etc. No, that is not done; instead we cross that bridge when we come to it. Of course it would be terrific if we all had lots of pretest counseling, became perfectly-informed patients, etc. But to stipulate it as a requirement, and by extension prevent testing when it does not occur, is in my mind wrong.
Once again, AIDS is a disease. We all benefit - those who are or will be sick most of all - from people knowing when they are infected/sick with a disease. Attempts to continue to treat AIDS as in a "special" category are wrong-headed, and a long time past their prime.