Tag HIV/AIDS

Thebody.com – New York State May Soon Finally Eliminate Explicit Consent From HIV Testing in Care Settings

By Tim Murphy, November 29

Laws about HIV testing have created decades-long controversy in New York State, pitting health officials who want virtually universal HIV testing against advocates — especially those who remember a darker, more discriminatory time — concerned about the privacy and protection of patients. It was that concern, after all, that in 1988 led to a stringent law requiring that health providers obtain from patients signed consent for HIV testing separate from consent for all other routine tests. And it was that same concern that, in the mid-2000s, led to mighty pushback from advocates when then-NYC health commissioner Tom Frieden tried to downgrade the law from written consent to mere oral consent, with the provider noting as much in their chart. That change did not occur until 2014.

But now, more than a decade later, there is solid evidence not only that early HIV detection and treatment means better long-term health outcomes, but that steady treatment makes people unable to spread the virus. It appears that most of the HIV advocacy community in New York City and the state at large now agree that the current law still obstructs testing for health providers — largely because they find it awkward asking patients if they can test for HIV.

These advocates agree that levels of testing high enough to truly end the state’s HIV epidemic cannot be achieved unless everyone who walks into an emergency room or primary care setting is routinely tested, with no notice to patients except for a sign on the waiting-room wall telling them they can opt out if they speak up and say so. And they are ready to lobby for that change with the state legislature in Albany next year.

On October 31, at the Brooklyn offices of Housing Works, representatives from that agency, Montefiore Medical Center, the large LGBTQ health provider Callen-Lorde, Bronx and Brooklyn Legal Services, the Latino Commission on AIDS, the National Black Leadership Commission on AIDS, Harlem United, the LGBT Center, Boom!Health, and other organizations met. According to Housing Works cofounder Charles King, “I think we came to a working consensus that we want to move HIV testing forward in a routine way.”

King said that the next step would be another meeting in which constituents write a rough draft of proposed bill language that would mandate that health facilities do routine HIV testing and that they post that information clearly in waiting or other public areas, letting patients know they must explicitly refuse HIV testing in order to not be tested.

More than a decade ago, Housing Works was among the leading voices against such a move, engaging in a sustained public protest against Frieden’s efforts that created acrimony between the city health department and much of the city’s HIV/AIDS services community. Thirteen years later, says King, “Less than 10% of all HIV-positive people in New York State don’t know their status,” and many of them are those whose only point of contact with health care is a visit to the emergency room — hence the need to test everyone in those settings.

“It’s imperative that we identify these folks and get them into care if we’re going to not only save their lives but stop all new infections of HIV in New York State,” says King.

He is part of the state’s Ending the Epidemic initiative, which aims to get new HIV infections in New York to 750 or below by 2020, as well as to make sure that the vast majority of all New Yorkers with HIV are both in regular care and virally suppressed on treatment. These are all necessary factors to effectively end the AIDS epidemic in New York State, historically the nation’s worst.

“In recent years, we’ve learned that the sooner someone with HIV starts on treatment, the better their outcomes,” King says. “We’ve also learned that someone who’s virally suppressed can’t pass on HIV. Those are huge game-changers that have tipped the balance in terms of whether it’s worth intruding on someone’s privacy.”

Donna Futterman, M.D., longtime director of the Adolescent AIDS Program at Montefiore, agrees. She’s long called for getting rid of requiring explicit consent from patients to HIV-test them. “The current stipulations are a proven barrier to more people knowing their status,” she says. “We want it to be part of a routine blood panel. Why do we still need HIV exceptionalism when it comes to testing? No one says, ‘Oh, we’re screening you for cancer,’ but often, routine tests are how you start to find cancer.”

She continues: “With HIV right now, a lot of nurses use unverbalized judgment on who they ask to be tested, based on race, age, or who they think is gay. They shouldn’t have to make that call. Thirty-five years into this epidemic, it’s time for us to let go of some of our old notions, especially now that we have the blueprint to ending this epidemic, and testing is the first piece of that.”

DNAInfo: City to Set Up Mobile Testing Site Outside Closed Chelsea STD Clinic

By Rosa Goldensohn

CHELSEA — City-backed HIV and syphilis testing will stay in Chelsea while the neighborhood’s public STD clinic closes for renovations, the health department announced Tuesday.

A mobile testing unit that offers syphilis and HIV tests will be stationed outside the clinic at 303 Ninth Ave. starting this summer, health department spokeswoman Veronica Lewin said.

The city will also send additional funding to clinics at Community Healthcare Network, Callen Lorde and Mt. Sinai Downtown to pay for extra testing and to add a nurse practitioner at each site, the department said.

Budget Season Photos

Photos credit – Assembly Photography

Opening remarks at VOCAL's HIV/AIDS Legislative Advocacy Day, with Senator Gustavo Rivera.

Opening remarks at VOCAL’s HIV/AIDS Legislative Advocacy Day, with Senator Gustavo Rivera.

Joint Conference Committee on Health meets on the budget

Joint Conference Committee on Health meets on the budget

More from the Joint Conference Committee, with Sen. Hannon (L), A/M Cahill (R), and A/M Raia (standing)

More from the Joint Conference Committee, with Sen. Hannon (L), A/M Cahill (R), and A/M Raia (standing)

Packing the stairs for the Share Better Coalition's rally against illegal hotels

Packing the stairs for the Share Better Coalition’s rally against illegal hotels

Speaker Heastie leads press conference before Assembly passage of Reproductive Health Act

Speaker Heastie leads press conference before Assembly passage of Reproductive Health Act

More budget conversations with Assembly Members Barron (L) and Titone (R)

Discussion with Assembly Members Barron (L) and Titone (R)

Speaking on the budget

Speaking on the budget

Photos for the Week of February 23

At work in the Chamber, with Assm. Charles Barron (credit: Assembly Photography)

At work in the Chamber, with Assm. Charles Barron (credit: Assembly Photography)

Speaking at Housing Works' "Ending the AIDS Epidemic" legislative briefing.  (Credit: Assembly Photography)

Speaking at Housing Works’ “Ending the AIDS Epidemic” legislative briefing. (Credit: Assembly Photography)

Chatting with Charles King, President & CEO, Housing Works. (Credit: Office of Assm. Gottfried)

Chatting with Charles King, President & CEO, Housing Works. (Credit: Office of Assm. Gottfried)

With Senator Hannon at VOCAL's Hepititis C Awareness Day (Credit: Office of Assm. Gottfried)

With Senator Hannon at VOCAL’s Hepititis C Awareness Day (Credit: Office of Assm. Gottfried)

With representatives of the New York Public Library (credit: Dan Katz)

With representatives of the New York Public Library (credit: Dan Katz)

Gay City News: Dick Gottfried, Gustavo Rivera Push Clean Needle Legalization

By Nathan Riley, January 22, 2015

A legislative proposal in Albany to reduce stigma, curb police harassment of drug users, and improve access to clean needles demonstrated broad support at a January 15 press conference in Manhattan.

State Senator Gustavo Rivera, who represents part of the Bronx, and Chelsea Assemblymember Dick Gottfried, both Democrats, discussed legislation they will introduce that would completely decriminalize syringe possession and lift restrictions on their sale in pharmacies. Distribution of clean needles to drug injectors in New York City has helped bring new HIV diagnoses among that group down from thousands annually to 89 in 2013.

Among those on hand with Rivera and Gottfried was Tracie Gardner, who has served as co-director of policy at the Legal Action Center and last month was named an assistant secretary of health by Governor Andrew Cuomo.

Capital NY: Bill Would Decriminalize Syringe Possession

Intravenous drug users would be able to purchase as many clean needles as they need and carry them without fear of police harassment under a bill proposed by Assemblyman Richard Gottfried and Senator Gustavo Rivera.

The bill, which would amend certain sections of the criminal and public health law, is a key recommendation of an anti-AIDS task force commissioned by Governor Andrew Cuomo.

The task force’s ambitious goal is to limit the number of new AIDS cases to 750 per year by 2020. In 2013, there were 2,832 new cases statewide.

City & State – Setting the Agenda: Health

By Ashley Hufpl, November 25

In the wake of Gov. Andrew Cuomo’s announcement in April that the federal goverment had approved an $8 billion Medicaid waiver so that New York can apply that money to reform the state’s healthcare system, the main goal of the state Senate during the 2015 legislative session will be to implement major healthcare system changes. Meanwhile, the Assembly will seek to pass publicly funded, single-payer health coverage.

With the waiver, the state will overhaul the current system to fully implement the Medicaid Redesign Team reforms, such as promoting community-level collaborations and lowering avoidable hospital admissions by 25 percent over the next five years.