Friday, August 04, 2006

Compulsory HIV testing in Washington DC

The UK Guardian recently reported that the city of Washington DC is planning to test every resident between the ages of 14 and 84 for HIV. The campaign called "Come Together DC, Get Screened for HIV" will be able to report on a person's HIV status within 20 minutes using the "saliva" based test. It is hoped that by December 31st all DC residents will know their HIV status. According to the Guardian, DC has the highest rate of contraction in the country with 180 new cases per 10,000 residents each year - or 1 in 50 DC residents are HIV+. The DC government's position is explained by spokesperson as
"If we are serious about addressing this epidemic in our community then screening for HIV has to become routine," Marsha Martin, the city official in charge of the programme, told the Washington Post. "Because we'll miss too many people otherwise ... We have to start making it part of the public consciousness, that HIV is of and among us."
When reading this I am reminded of the New York experiment to treat HIV+ children in care as guinea pigs using experimental toxic drugs. Children as young as three months were fed and in some cases force fed these toxic drugs. The children were the most vulnerable members of the community - many were orphans, others were fostered, most were children of black and came from run down neighbourhoods in New York. Returning to Washington DC's plan to enforce every citizen to undergo an HIV saliva test sets a dangerous precedent. The city has a majority Black population many of whom are extremely poor and the project is yet another example of how black and poor people in the US are being treated with regards to HIV. The idea of forcing people to undergo HIV tests, the results of which will no doubt be used by employers, landlords, hospitals and other public services is unethical and alarming. Firstly the saliva test itself is not a reliable test and therefore many people will come away from the tests with false information and the city will not have accurate data on the HIV status of it's citizens. Secondly because of the speed of the test (20minutes) there is no opportunity for people to receive pre and post test counselling which has been established as an essential precursor to HIV testing. The organisers claim they will provide counselling but it is difficult to see how this will take place if the test itself only takes 20 minutes and provides an instant but unreliable result.

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1 comment:

HRW AIDS said...

A couple of important clarifications here -

1) the plan in DC is "routine" not "compulsory" - the difference being that there is no plan to mandate testing of everyone in DC. Routine testing has its own problems in terms of ensuring that there is informed consent, and counseling (but it can - and should take place before the test is conducted, not in the 20 minutes that it takes to get the result) and ensuring appropriate links to treatment, but mandatory testing would be another thing entirely.

2) there is a lot of controversy around the "experiment" with children that is mentioned. Jeanne Bergman had an article in the New York Press about it which talks about the history of the protest and the involvement of AIDS denialists -
http://www.nypress.com/18/25/news&columns/bergman.cfm - It says, in part:

"The attacks on Incarnation Children's Center began with a sensationalist stew of lies, partial truths and innuendo cooked up by an AIDS denialist and free-lance writer named Liam Scheff and circulated on the Internet in early 2004. The New York Post picked up the story in March of that year, eliciting a spasm of misinformed grandstanding by a couple of City Council members. Scheff got New York Press to print his story that July [vol. 17, issue 28]. But his claim that children at ICC were being tortured in hideous experiments by a cabal of plotters including the National Institutes of Health (NIH), the Catholic Archdiocese, GlaxoSmithKline, Columbia-Presbyterian Medical Center, and the Administration of Children's Services wasn't taken seriously until the story was rendered by people with British accents on BBC Two in November 2004. Regrettably, the HIV denialists driving this hoax have since been joined by African-American activists affiliated with small groups like the December 12th Movement, whose rage is directed primarily at ACS. They started organizing protests outside ICC, thus outing the residents as children with AIDS and characterizing their home as a "slaughterhouse.""