Wednesday, September 27, 2006

CDC recommends routine testing: Ignores stigma?

The Center for Disease Control and Prevention revised their recommendations on September 22 regarding HIV testing. Now, the CDC urges that all teenagers and most adults receive HIV tests as part of routine medical care. Further, it advocates dropping previous guidelines of pre-test counseling and signed consent forms.

This proposal prioritizes expansive testing over efforts to inform people about high-risk behavior. A study of AIDS cases in 33 U.S. states between 2001 and 2004 showed that over 60 percent of HIV cases are due to male-to-male sexual contact or injection drug use (MMWR 54(45); 1149-1153). The heterosexual partners of MSM and IDUs must also be considered in this statistic. Education and counseling about high-risk behavior is crucial to curbing the epidemic. In the case that people engaged in risky behavior test negative, without counseling there is little motivation to change that behavior or change in risk perception.

Dr. Julie Gerberding, the disease control agency’s director, said, “People with HIV have a right to know that they are infected so they can seek treatment and take steps to protect themselves and their partners.'' But what exactly is the CDC doing to facilitate these steps? People cannot take steps on their own without counseling about their status and guidance through the system. The CDC might take on a leadership role in funding needle exchanges and comprehensive sex education in schools, for example.

The New York Times called the move “a sharp break from the early days of the AIDS epidemic, when the stigma and fear of social ostracism caused many people to avoid being tested”. In fact, stigma around AIDS and sex is still very much alive in the United States. Education policies around abstinence both exemplify and exacerbate this stigma. They affirm the destructive stance that those infected have failed to adhere to moral policies.

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