One of the plot-lines I remember most vividly from the Gen X coming-of-age opus Reality Bites is the bit about Janeane Garofalo’s character getting an HIV test. She’s totally freaked out about it, and not only does she have to visit a special HIV clinic for the test but she also has to wait weeks for the results (spoiler alert: it’s negative). Contrast that to today, when test results are available in as little as 20 minutes, drug stores sell at-home HIV tests and, soon, getting screened for the virus during doctors visits could be as routine as having your blood pressure taken. We’ve come a long way, baby — and some might even say too far.
According to Reuters, the U.S. Preventative Services Task Force — the same panel that brought us “free” birth control– is set to update its current position on HIV screening, issued in 2005, which leaves the decision up to doctors. Health officials say the panel will soon recommend routine testing for HIV as part of any general battery of blood work. Health insurers would have to cover the tests, since part of the 2010 health care reform law requires insurers to cover all preventative services the task force endorses. Adding an HIV screening to a routine blood exam would cost about $1.50 per patient, Reuters notes.
Because getting HIV in America is no longer a death sentence (and hasn’t been for a while), it’s easy to forget how common and devastating the virus still is. But according to the CDC, nearly 60,000 new cases of HIV are reported each year. An estimated 1.2 million Americans are living with the disease, of which some 240,000 are likely unaware they have it.
“All healthcare providers have a responsibility to find cases of HIV because we don’t know where they are,” said Lisa Fitzpatrick, who directs the United Medical Center HIV clinic in Washington. While doctors in the past focused on higher risk groups such as men who have sex with men, she said, “HIV is in the general population now.”
The CDC has already called for routine HIV screenings at physician visits, which could reach a much broader swath of the population, including folks who would never go to an HIV clinic or a place like Planned Parenthood for the test. Catching the disease earlier could not only extend the lives of people infected but help stop the disease from spreading. When started early, new HIV medications can cut the risk of transmitting HIV to sexual partners by 96 percent.
Still, the test is likely to be quite controversial. Remember the hoopla surrounding the inclusion of birth control as a covered preventative service? Some of the ire came from traditional champions of limited government, but a good portion came from religious and social conservatives, who (among other arguments) didn’t want “to be paying for other people to have sex.” [Those months shall be remembered as the great heyday of the 'I'm-on-birth-control-for-my-migraines/menstrual cramps/acne' articles.] You can be certain the same arguments will be bandied about should this HIV screening rec progress.
But this time, I don’t expect it will only be conservatives with qualms. Finding out you have HIV isn’t like finding out you have high blood pressure. Are general practitioners equipped to deal with telling people their HIV status? Should they have to be? And will patients want to know? As terrible as it sounds, I’m sure a lot of people would rather not. Could routine HIV blood testing actually discourage people from health care?
The pros outweigh any of these cons in my book, and yet something about this still makes me squeamish. What do you think? Would you welcome routine HIV screening as part of your regular doctor visits?
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