Report: Michigan fails to make AIDS tests routine

First of a four-part series on AIDS in Michigan.

More than a year after the federal government changed HIV guidelines to recommend testing for everyone ages 13-64 as part of a yearly physical, the Michigan AIDS Fund has released a report card claiming the state has failed at making such testing routine.

The Centers for Disease Control and Prevention (CDC) in Atlanta changed its HIV testing recommendation in September 2006. Until then, the CDC recommended testing only for those in high-risk groups such as men who have sex with men or intravenous drug users.

But “there continues to be far too little routine HIV testing in medical settings,” the AIDS Fund said Thursday in the introduction to its report card. The fund was formed to help distribute private and public grants to fight HIV.

In the section evaluating HIV prevention in the state, the report goes further: “We have failed to make routine testing and screening for HIV a routine part of medical care, missing an important opportunity to identify infected individuals and linking them to critical care and support services.”

Continued -The report, compiled by state AIDS service organizations, gives the state a B- for care and treatment options, a B- for funding, a C for HIV prevention and a C in public policy work on HIV/AIDS.

The federal recommendation to expand testing was made in part because a growing body of medical literature shows early detection and intervention for those with HIV leads to a better health prognosis. The report cites numerous new HIV drugs on the market that are generally very effective in slowing the progress of the infection and delaying or preventing the onset of AIDS.

The 27-page report also recommended:

• Eliminating mandatory pre- and post-test counseling
• Making HIV tests routine unless a person opts out of the process
• Requiring testing only from health-care providers, not from AIDS service organizations that offer confidential or anonymous HIV testing.

“I believe in the CDC recommendations,” said Kaye McDuffie, early-intervention coordinator for the Lansing Area AIDS Network. But her support is only for increased testing, not for the report’s other recommendations. “I feel that if there is not time to do some sort of assessment to let the patient know what he/she is doing [that] is putting them at risk, then they can’t develop effective strategies to eliminate risks.”

Jihannh Jones, program coordinator and HIV test counselor for the Midwest AIDS Prevention Project, echoed McDuffie.

“I don’t agree with” not requiring pre- and post-test counseling, Jones said. “You never know what a client is going through. You need to know what is in their past. I think that is very important.”

However, opt-out testing may not be a choice in Michigan. State law requires all people being tested for HIV must be told in advance about the test and must sign a consent form. The law also requires anyone seeking HIV testing be counseled about HIV risks and prevention.

The call to recommend pre- and post-test counseling was made in part to alleviate concerns expressed by the medical community, the CDC report said. Medical professionals expressed concerns about having frank conversations on sexual behavior with their patients, as well as concerns that the average doctor did not have time for counseling because of time constraints placed on them by managed-care programs.

Watch Michigan Messenger for Part 2 in this series, covering barriers to HIV testing.

Remember World AIDS Day on December 1; find HIV testing locations near you.