More than 30
states have laws barring doctors from heeding a call by U.S.
health officials to routinely test Americans for the AIDS
virus, researchers report. And states don't seem to be
in any rush to change that.
None have chosen
to remove all barriers since the Centers for Disease
Control and Prevention announced new testing guidelines last
year, the researchers said in a new study Tuesday.
''I think if they
were going to change, they would have done so by now,''
said Lawrence Gostin, a public-health law expert at
Georgetown University. He was not involved in the
research but agreed with its findings.
But CDC officials
disagreed. They cited more than a half dozen states
that have made some kind of law change to simplify HIV
testing. Other changes appear to be pending in
California and other states, they said.
''I don't think
it's a done deal,'' said Bernard Branson of CDC's HIV and
AIDS prevention division.
The agency's
recommendation that all teens and adults under age 65 be
tested for HIV when they visit doctor's offices, emergency
rooms, and other health care centers was hailed by
some HIV patient advocates and health policy experts.
Supporters said the guidelines could help end the
stigma of HIV testing and lead to needed care for an
estimated 250,000 Americans who don't yet know they
have the disease.
CDC officials
said they believed the guidelines would make testing
simpler by sparing primary care doctors from having to
counsel patients before the test and from getting
specific consent to test for HIV. They acknowledged,
however, that some state laws might pose an obstacle.
The new study,
released Tuesday in the online journal PLoS One,
provides new information about the extent of states' legal
barriers.
The researchers
used legal databases to search state laws and look for
recent amendments. Their results were current through July.
They did not count proposed legislation.
They found that
33 states require informed consent for an HIV test. And
24 states require disclosure of information about the
testing and disease, either in pretest counseling or
in a consent process.
Both requirements
are barriers to the CDC guidelines as currently
written, said Leslie Wolf, an associate professor of law at
Georgia State University who is the study's lead
author.
They found only
two states -- Rhode Island and Illinois -- that took
action with the stated intent of trying to better comply
with the CDC recommendations. But both states left
some form of informed consent or pretest counseling
provision in place, Wolf said.
It's unlikely
there will be much additional legislation, now that the
news splash about the new guidelines has ended, Gostin said.
''The political
impetus was then, and they're on to other things,''
Gostin said of state legislators.
The CDC doesn't
know how many states have some form of legal barrier,
partly because laws are subject to multiple interpretations,
Branson said.
''It depends how
you classify 'barriers.' I can't comment specifically on
this study and how they came to their conclusions,'' he
said.
He listed seven
states that he said recently modified their informed
consent laws in a way that better conforms with CDC
recommendations -- Illinois, Iowa, Indiana, Louisiana,
Maine, New Hampshire, and New Mexico.
California's
legislature passed such a bill last month, and that state
will make eight if Gov. Arnold Schwarzenegger signs it,
Branson said.
Branson said
there is no national data yet to indicate what impact the
CDC guidelines have had. (AP)
