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National HIV Testing Day: A delicate balance

The US has jumped on the routinized testing bandwagon. But a balance must be struck between making testing more widely available, and making sure patients have enough time and resources for counseling if they test positive.
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A man reads education literature as he waits for an HIV test at a free mobile testing center in Los Angeles. (Robyn Beck/AFP/Getty Images)

The goal of National HIV Testing Day (NHTD) is to encourage routine testing and early detection of HIV, according to the National Association of People with AIDS, the organization that founded NHTD 18 years ago.

And throughout the country, organizations and governments are working toward this goal. Indeed, the US has jumped on the routinized testing bandwagon.

The American drugstore chain Walgreens announced today that it has partnered with the CDC to offer free HIV testing in some of its stores. The idea of this pilot program is to make HIV testing more accessible to the American public.

“Our goal is to make HIV testing as routine as a blood pressure check,” Jonathan Mermin, director of CDC’s Division of HIV/AIDS Prevention, told Reuters.

In Massachusetts, a law will take effect next month that requires verbal consent from patients before an HIV test can be given, as opposed to necessitating written consent, which is the commonwealth’s current requirement.

“This bill will lead to more lives being saved,” said Governor Patrick when the bill was signed in April. “By removing barriers to screening, we will continue to decrease rates of HIV in our communities.”  

Massachusetts was the second to last state in the country to change its law to require verbal consent (Nebraska is the only other state where written consent is needed).

According to the CDC, nearly 20 percent of the 1.1 million Americans living with HIV/AIDS do not know they’re infected. Without that knowledge, of course, HIV positive people risk not knowing to seek treatment until it is too late.

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But here’s the catch – there’s a delicate balance that must be struck when it comes to making HIV tests routine, said Larry Day, Manager of HIV Health Promotion at the AIDS Action Committee of Massachusetts.

Day knows this from experience, because he was diagnosed with HIV in April, 1996, after being tested without giving his consent. He arrived at the hospital sick, and the doctor tested him for HIV without his knowledge. Without the opportunity for counseling or a conversation with the doctor, he said, he wasn’t mentally prepared to hear the news.

According to Sarah Freedman, pharmacy manager at the Walgreens in the Foggy Bottom neighborhood of Washington, DC, three pharmacists at her store were given nearly five hours of training in how to administer the test, counsel patients, and link anyone whose test comes back positive to confirmatory tests and care.

“We don't do too much intensive counseling, but we do give some counseling,” she said. “We would never have anyone leave that doesn't feel secure with the information we were giving them.”

Freedman said that once patients are given the results, the pharmacy does everything it can to make confirmatory tests and links to care as easy as possible. If necessary, she said, they will even walk patients to the facility that does confirmatory blood tests. She added that she didn’t think patients received any less counseling when tested at her pharmacy than at a doctor’s office.

Day does agree with the country’s bandwagon jumping; he still thinks making HIV testing easier and more widely available is important.

But as we make access to testing ever easier, Day’s story is a reminder not to forget about the emotional turmoil that accompanies a positive result.  

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http://www.globalpost.com/dispatches/globalpost-blogs/global-pulse/national-hiv-testing-day-delicate-balance