Legislative Advocacy

Support for California AB 446: Universal HIV Testing

Hon. Governor Edmund “Jerry” G. Brown, Jr.
California State Capitol
Sacramento, CA 95814
FAX: 916-558-3160 (2 pp)


Dear Governor Brown:

Beyond AIDS asks that you sign AB 446, a major advance in the effort to control the HIV/AIDS epidemic in California. Beyond AIDS is a national organization, founded and directed in California, which is dedicated to controlling the spread of HIV/AIDS. I have personally been in charge of HIV testing programs, and have been an HIV clinician and a past county health officer.

Over the past 2-3 years, studies have shown that HIV treatment can reduce transmission of the virus by 96%. Therefore, if we could identify almost everyone who is infected, and treat all those persons before they passed the virus on, we could totally control the disease, with fewer new cases every year. The cost savings to the state and the prevention of illness and death would be immense. The problems preventing that from being achieved are that 17 20% of infected persons have not been tested, and among those who do test positive, only 30% (or 25% of all infected persons) get started on medication resulting in suppression of the virus (data from Centers from Disease Control, CDC, 2012).

On the other hand, for pregnant women in California, almost all get tested, and almost every woman who tests positive is treated. As a result, we have practically eliminated the occurrence of infections in newborn babies. The reason for these excellent results is that California has for years required the offering of HIV testing to all pregnant women, and post-test counseling that refers the infected ones for treatment. Those requirements have not existed for other patients until now, but will be added by AB 446. AB 446 will require primary care providers to offer an HIV test to adults and adolescents if other blood tests are already planned, and will add a post-test counseling requirement.

AB 446 also permits oral opt-out consent for HIV testing in non-clinical settings, which is already permitted in physician’s offices. This helps to avoid the barrier to routine testing that is caused by requirements for written consent. AB 446 also facilitates confidential posting of test results and post-test counseling information on secure Web sites, so that patients who cannot return to a provider’s office can obtain this information.

AB 446 will be cost-effective for the state. By mandating the offering of HIV testing by primary care providers, cases will be discovered and patients entered into treatment (making them almost non-infectious) before they transmit the virus to others. Countless new cases that the state would have had to pay to treat will be prevented. HIV that is discovered early is less expensive to treat, and the expensive stage of AIDS (often requiring hospitalization) can be prevented.

Once again, we urge that you sign AB 446 (Hall), as an excellent and cost-effective public health measure that will be a proud addition to California law.


Ron Hattis, MD, MPH
President, Beyond AIDS
Mobile: 909-838-4157
Personal e-mail: ronhattis@aol.com

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