CMA ENDORSES ROUTINE HIV TESTING, USE OF NAMES
Organization Also Supports Use of Reported Names for Partner Notification, Referrals
On October 30, 2006, the California Medical Association (CMA) House of Delegates, meeting in Sacramento, adopted two important resolutions on HIV prevention. One resolution endorses September 2006 recommendations from the Centers for Disease Control and Prevention (CDC) for routine HIV testing in health-care settings, without written consent. California and many other states currently require written consent for HIV testing.
The other resolution calls for the use of the state's new name-based HIV reporting system for purposes of partner notification, other prevention efforts, and referring persons who test positive for medical care and treatment. Some AIDS advocacy groups in the state supported the bill that established the new reporting system in April 2006 as a means of assuring federal financial support, but oppose use of the names except for statistical purposes.
The resolutions were supported by the California Academy of Preventive Medicine, the state's specialty society for physicians specializing in public health and prevention. The Academy, which was represented as part of CMA's Specialty Delegation, has long supported the application of standard public health measures to fight the HIV/AIDS epidemic.
The author of the resolutions, Ronald Hattis, MD, of Redlands, California, also credited support from Physicians for HIV Control (PHC), a network of doctors committed to working through organized medicine to achieve better control of HIV transmission. A number of physician members of the group were delegates at the CMA meeting. Hattis, who is secretary of PHC, said that the group was founded in 1998 by members of the California Medical Association dissatisfied with CMA's reluctance at the time to support legislation to make HIV reportable by name. Pressure from this group is credited with eventually making CMA a firm supporter of such legislation. The group has since enlisted physicians from other states, and has worked closely with an allied organization, Beyond AIDS.
Here is the full text of the two resolutions, which will constitute official policy of organized medicine in California for the next 10 years unless revoked.
HIV TESTING CONSENT
RESOLVED: That CMA support the 2006 CDC recommendations for routine, “opt-out” HIV screening including:
In health care settings:
- HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
- Persons at high risk for HIV infection should be screened for HIV at least annually.
- Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
- Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings.
For pregnant women:
- HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
- HIV screening after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
RESOLVED: That CMA widely disseminate its legal counsel’s opinion that hospitals and independent laboratories are entitled to rely on a physician’s order and not require separate written consent; and be it further
RESOLVED: That CMA reaffirm its commitment to supporting legislation to make HIV testing similar to all other medical testing in this state, and that CMA cite and utilize the new CDC guidelines in this effort.
UTILIZING HIV REPORTING FOR PREVENTION, REFERRALS
RESOLVED: That CMA support the use of HIV reporting for purposes of promoting prevention and referral for early treatment, and that CMA reaffirm its position that a primary purpose of such reporting is to achieve partner notification and disease control; and be it further
RESOLVED: That CMA support funding for adequate treatment and for partner notification of all HIV infected persons.
Return to Archived Articles and Letters