Dec. 1 was World AIDS Day and, while we have so many achievements to celebrate, we also have many challenges that demand increased and improved efforts to curb the HIV epidemic that has now spanned more than 30 years in the United States. The past 30 years have seen tremendous progress made in the prevention and treatment of HIV infections. However, not all Americans have benefited equally from the advancements seen in HIV testing technology, HIV prevention strategies, and HIV treatment.
According to the 2014 CDC State HIV Prevention Progress Report, "The burden of HIV infection, the reach of HIV testing, and the health of people living with HIV vary widely across the United States." In 2006 the CDC released guidelines recommending that all individuals ages 13-64 be tested for HIV at least once in their lifetime, and more frequently for those with increased risk. Illinois is one of several states categorized as having a "High HIV Burden", and among those states Illinois is one of the worst ranked for a ) number of persons ages 18-64 who have ever been tested and b ) number of HIV-positive individuals linked to and retained in medical care.
More than eight years have passed since the CDC's Routine HIV Testing Guidelines were released, and routine HIV testing is now covered in Illinois by Medicaid, Medicare and private insurance as an annual preventive screening. So why do we still have so many people in high-prevalence neighborhoods in Chicago and throughout Illinois who have never been tested for HIV? While the answer to that question is certainly complex, throughout the country many research studies have shown that complex and burdensome state HIV testing laws are a significant contributing factor to hospitals, clinics, and providers not incorporating routine HIV testing into their patient care.
In Illinois, the AIDS Confidentiality Act and its corresponding Administrative Codes establish strict and narrow requirements for who can provide pre-test information and acquire informed consent for HIV testing, which create barriers to routine HIV testing in medical facilities. It is very important that patients' rights and confidentiality are upheld, and removing barriers to routine HIV testing need not compromise those priorities. It is time to revise our Illinois HIV testing laws and codes to ensure that providers can more easily incorporate HIV testing into their routine patient care. One in six individuals living with HIV in Chicago is unaware of their status and routine testing is imperative to reduce the number of undiagnosed HIV-positive individuals living in our city and, subsequently, the number of new HIV infections.
Cammeo Mauntel-Medici, MPH
Project Manager, Project HEAL
University of Illinois Hospital & Health
Sciences System, Chicago, Illinois