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
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