Austin Public Clinics to Provide Opt-Out HIV Testing

Great news via the Statesman.

Seventeen public health clinics operated by Travis County's CommUnityCare will begin providing opt-out HIV testing to adult patients beginning in January. The CDC recommended in 2006 that HIV testing be a part of routine health care for all adults, because the public health authority estimates that a large percentage of those infected with HIV are unaware of their status. Presumptive testing includes HIV in the regular battery of tests an adult receives at a checkup, like blood pressure, cholesterol, and so on, and a patient must "opt-out" not to receive the test.

Presumptive testing is controversial because in public clinics, where patients may have no access to other, expensive health care services (and in Texas, where Medicaid is incredibly restrictive, this is often the reality), an HIV diagnosis could be considered a death sentence. When the New York City health department and hospitals in the Bronx implemented opt-out testing in emergency rooms some HIV rights activists raised concerns that doing so reduced the likelihood that patients would undergo the informed consent process, which (though required by law) has been shown to reduce the chances that a person will get tested. The then-head of the NYC department, Thomas Frieden, is now the head of the CDC.

Considering that Texas has the 4th highest number of AIDS diagnoses in the country, behind epicenter states California, Florida and New York, moving toward presumptive testing is a good idea. I hope that a commitment to providing access to care for those diagnosed with HIV/AIDS will follow, because Texas has the highest percentage of the population without health insurance of any state, and HIV meds are expensive as hell.

Until there's a cure...

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