By Rebecca Haag
If you don’t know your HIV status, you should.
Today, it’s easier than ever in Massachusetts to learn your status through your doctor thanks to a change in the state’s HIV testing law that goes into effect on July 26. This new law, “An Act to Increase Routine Screening for HIV,” modernizes the Commonwealth’s HIV testing laws by replacing the need for written consent before an HIV test can be administered with verbal consent. The new law still maintains all privacy protections for patients that were present in the old law.
With an estimated 26,000 to 28,000 people living with HIV/AIDS in Massachusetts, but approximately 21percent of them unaware that they are HIV positive, it’s clear that we need expanded HIV testing of state residents to end the epidemic. Expanded testing in communities like Boston should make an impact; the city ranks second out of the state’s top 15 municipalities with the highest rates of new diagnoses of HIV infection. Statewide, about one-third of those who learn that they are HIV positive are also diagnosed with AIDS within just two months of their HIV diagnosis, which shows that they may have been HIV positive for years without knowing it — and without their health care providers ever suggesting that they get tested for HIV.
Increased HIV testing will help get those who are HIV positive into care and treatment earlier and will result in better health outcomes and lower health care treatment costs. Earlier testing for HIV will also help prevent the spread of new infections since those who know their status and are in treatment are much less likely to transmit the virus to others.
Massachusetts has long been a national leader in the fight against AIDS. New diagnoses of HIV have declined by 54 percent since 1999 which will result in $2 billion savings in health care costs. At approximately 650 new diagnoses annually, we are tantalizingly close to eliminating the spread of HIV in Massachusetts. A critical tool in this fight will be the ability to more easily test those who are most vulnerable to HIV infection, including people of color and gay and bisexual men.
Black residents make up just six percent of the state’s population, but 30 percent of those who are living with HIV/AIDS. Hispanics/Latinos make up eight percent of the population but comprise 25 percent of those living with HIV/AIDS. Forty-four percent of women living with HIV/AIDS in Massachusetts are black, and 28 percent are Hispanic/Latina. Meanwhile, male-to-male sex accounts for 40 percent of those recently diagnosed with HIV in Massachusetts, making it the most common way people in Massachusetts become HIV positive.
All that said, it is clear that we can’t test our way out of the epidemic. In 2009, between June 27 and July 29, 2009, AIDS Action Committee held five town hall-style meetings to solicit feedback from providers, patients, and activists in Boston, Worcester, Springfield, Gloucester, and Brockton around current testing practice. We learned that stigma around HIV testing prevents some people from getting tested. We learned that some people who are vulnerable to HIV infection fear losing health care insurance if they test HIV positive and so they have not been tested. We also learned that there is a profound lack of confidence in the confidentiality of HIV tests.
Now that the challenge of expanding HIV testing is behind us, we need to work together with the medical and public health communities to find a way to reduce stigma. We also need to ensure that all relevant medical information is securely in the hands of physicians who need it. And as we continue to move toward universal electronic medical records, we need to find ways to address patient concerns about confidentiality and ensure their full participation in the process.
In the meantime, the single most important thing you can do to end the epidemic is to learn your HIV status.
Rebecca Haag is the President & CEO of AIDS Action Committee of Massachusetts.