PAGE6Q-Notes ■ February 1991 Political Concerns Overshadow Public Health Concerns By Paul Faldutu ACT-UP Triangle Special to Q-Notes A diverse and impressive group of doc tors, lawyers, public health workers, AIDS activists, gays and lesbians, ,social workers, PWAs have endorsed the continuation of anonymous testing for the HIV virus at three recent public hearings held by the North Carolina Commission for Health Services. Over 90% of the 70,pet>ple who jiresented oral testimony at the hearings in Raleigh, Wilmington and Winston-Salem during the week of January 14 op}X)sed the State Health Department's pro}X)sed change in state regu lations which would limit anonymous test ing, now available at all 100 county health deiiartments, to only twelve sites on July 1 of this year, and end all anonymous testing in North Carolina on January I, 1994. After that date, only "confidential" testing would be available and the names of all persons testing positive would lie reported to the state. Three additional public hearings will l>e held during the week of January 21, and the Commission will make its decision on Feb ruary 12. Should the Commission decide to retain anonymous testing, as it did last year, the Martin Administration will certainly ask the General Assembly, which goes into session on January 30. to override the deci sion. The Joint Committee on Legislative Operations, whose only function is to rec ommend legislation to the full General As sembly. recently endorsed an inwieclkUe entl to all anonymous testing in the state. Until alxmt six months ago. the State Health Department was a strong piojxinent of anonymous testing. the International AIDS C'onfcrence m San Francisco last June, the Department bragged of its success in convincing "at-i isk" persons to be tested. Ibe Deivulment presented a paper which concluded: "We believe that many persons at risk lor HIV will not seek counseling and testing if all persons testing positive are reported by name. Theietore we feel a com bination of named reponiiig and anonymous testing maximizes the number of persons at Hsk who access the HIV counseling and testing services and the number of partners notified and counseled appropriately." In 1989, State Health Director Ron Levine stated "Making HIV reportable would add little, if anything, to our ability to monitor the HIV epidemic or to control spread. It might, in fact, compromise our control by limiting our access to high-risk individuals who are frightened of recognition, disclosure and discrimination.” According to the Health Department now, things have changed. Better treatment is available. Confidentiality and anti-discrimi nation laws are on the books and provide protection for infected persons. \ Partner notification programs are in ef fect and work better with confidential, rather than anonymous testing. And finally, the distrust felt by many gay men and IV-dmg users is lessening, and more people are chix)sing confidential testing. Testifiers at the hearings repeatedly re futed these arguments. Roz Savitt of the North Carolina AIDS Services Coalition agreed that better treatment programs may lx; available, but noted that "access to and affordability of such treatments are beyond the financial means of many jieople." Dr. John Bartlett, principal mvestigator at Duke's AIDS Clinical Trials, where over KXX) HlV-infected people are being treated, alstr noted that the state "has ncX plannetl well for the profxjsed changes; we aren't ready with treatment and education programs." And such state sup[X)it is not likely to lx; forthcoming; at his weekly press conference on January 17. Governor Martin, citing the state's fiscal vvexjs, refiised to commit to increaseii state funding for treatment. Gov. Martin also said that "confidential testing has proven to be historically suffi cient to jireiscn^e practical anonymity." This argument is "a sham." according to Durham attorney Sherie Rosenthal. "Confidentiality is compromised daily and chronically; it's human nature. Communities are small and gossip has wings." Kathy Ashby of Fayetteville, a hemo philiac who has AIDS, poignantly testified to the truth of this statement. She told the Commission that a nurse at the hospital in Virginia where she was tested told others in the town about her illness. Subsequently, her child was barred fiom kindergarten, her husband lost his job, and child abuse charges were filed against her. Ultimately, she and her family were forced to leave town. She said she would not let her hiLsband be te.sted if anonymous testing were not available and would advise others against testing, too. If testing is not anonymous, she added, "somewhere, somehow, someone will find out, and it may not be you that suffers, but your children or someone else in your fam ily." Alx)ut the only agreement that testifiers had with the state is that people don't trust the system, and with good reason. Barbara Sara, HIV Co(X‘dinator at the New Hanover County Medical Center, contended that the health care system lacks credibility. She noted that, of 561 hospitals respond ing to a recent survey published in the AMA Journal, 22% did not require informed con sent before testing for HIV, 25% did not require that patients testing positive be no tified, 17% had no written policy on testing, 33% had no requirement that pre- and post test counseling lx; given, and 15% did not test all patients, only tho.se they suspected of being infected. Add to these sotx;ring statistics the many Iweaches of confidentiality, and all it takes to be distru.stful of the system, said Dr. Katherine Bell, a clinical psychologist at the Commu nity Wholistic Health Center in Carrboro, is "a jnilse and an IQ higher than pencil lead." Given the overwhelming success of and support for the continuation of anonymous testing, the obvious question is why the state wants to alx)lish it. Wilmington businessman Bob Jenkins thinks he knows why. "It's the smokescreen of politics," he said, "it's all about money and pohrics." According to activist Leo Teachout, anonymous testing "is a public health issue that the Administration would rather have decided out of political concerns than public health concerns." ACT-UP member Mark Zumbach added that "the proposal to eliminate anonymous testing Ls not motivated by thoughtful public health concerns, but by a }X>Iitics that .shows both a blatant lack of concern for sound public health [wlicy and an alarming insen sitivity to people who are HIV positive or in high-risk groups." Spearheading foe effort to abolish anonymous testing is a small group of con servative physicians and their political al lies, who have organized a state chapter of the Americans for A Sound AIDS Policy (ASAP). This "small group of physicians" are "addicts to their privilege," said Rosenthal. Others contended that doctors supporting ASAP want to identify infected people so they will not have to treat them. ASAFs definition of a sound AIDS poUcy, added Salak, is one that lacks any provi sions for the compassionate medical and social care of peopfo with AIDS, and is mo.stly concerned with the rights of physi cians to refuse to treat people with AIDS over the rights of (these people) to receive medical treatment that allows them dignity and affords them compassion." Teachout succinctly siunmed up the case for anonymous testing: "The end of anony mous testing means fewer people will be tested. How'will the .state provide follow-up if people never get tested in the first place'.' If individuals will not be tested in a 'confiden tial' setting, then how will they know they have HIV Infection, how will they know to seek medical care, and how will their part ners be notified and counseled'?" Co.ii364-1467 II Feb. 14th Valentine's Day 1^" ••••••••••••••••••• The Miss Charleston USA At-Large Pageant For information, call Heather Welles at (803) 577-9160 d / / III' 0 % % L • " • • ‘iV Show Director Heather Welles For booking information, call Wednesday evenings 8 pm - 2 am THE HRCADE CLUB LIBERTY STREET CHARLESTON. SC Shows Every Sunday f803J 577-9160 |