Thursday, June 26, 2008

NYC Health Dept Proposes HIV Testing Every Bronx Adult

Joe.My.God has the goods on a peculiar proposal to attempt to test every single adult (18-64) of the Bronx, which had New York City's highest death rate from AIDS in 2006. The front page New York Times article on the issue says:

While Manhattan has long been the epicenter of the AIDS epidemic in New York, with the highest incidence of both AIDS and H.I.V., the virus that causes it, the Bronx, with its poorer population, has far more deaths from the disease. Public health officials attribute this to people not getting tested until it is too late to treat the virus effectively, thus turning a disease that can now be managed with medication into a death sentence.

Several AIDS experts said on Wednesday that the Bronx campaign was the most aggressive testing effort they could recall in the nation. Two years ago, Washington, D.C., made a high-profile push to test 450,000 residents, enlisting celebrity endorsements and distributing 80,000 free testing kits, but the campaign resulted in only about 45,000 people being tested.

“What’s new here is that we are implementing it on this large a level,” said Dr. Donna Futterman, director of the adolescent AIDS program at Montefiore Medical Center in the Bronx, who helped New York develop the new program. “The Bronx has 1.3 million people. It’s bigger than most cities, bigger than Boston, bigger than Washington. We’re talking about a significant urban population.”

City officials estimate that 40 percent of the 830,000 people ages 18 to 64 in the Bronx have been tested for H.I.V. in the past year. Half of the remainder, about 250,000 people, have never been tested, and the goal is to test them first. Tests would be given at 40 designated sites, including clinics, community centers, churches and emergency rooms. Dr. Monica Sweeney, an assistant health commissioner for H.I.V. prevention, said the city had not set aside money specifically for the program, but would absorb the $12 cost of each test.

National HIV Testing Day is Friday June 27th. I'm very glad to see that New York City officials are getting serious about HIV testing in an urban population, although I do wonder how this program will go together with my report last week that New York City has been experiencing a curiously high false positive rate with certain oral HIV tests.

It's unfortunate that some bloggers are using the call for universal HIV testing as a rationale to relax protections on consent and counselling for HIV tests in New York State. Over my objections, California enacted AB 682 last year, which removed the legal requirement of post- and pre- test counselling in California, in an attempt to "routinize" HIV testing in the state.

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