Wednesday, September 20, 2006
debbie it's good to read your comment and think that things could have seemed so insurmountable initially in the u.s. too, and we've really come so far- so possibly also for africa- though i'm not sure the condom will ever catch on. as for me i spend a lot of my time now on the bio-intensive ag. demo plot which is great physical work and spectacularly beautiful- then i also am meeting one by one with the players of this agg. program to ilicit info. on how we are stuck and how to move forward- concensus is that we need partner w/ marketing experts- meeting on that next week
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These have been in the works for quite awhile. I thought that folks may be interested in the major change to public health policy regarding screening/testing for HIV/AIDS in the US. Personally, I have very mixed feelings. The ramifications for people who test positive for HIV/AIDS are far reaching, just not the same for people who test positive for high blood pressure or thyroid disorders (for example). The arguments for this kind of population based testing make the claims that it is no different.
Women have not been beaten up for testing positive for high blood pressure, people are not denied health insurance or entry into this country for testing high for blood pressure. Although, for the benefit of public health -- it is important that everyone knows their status. I certainly don't trust that every health care provider will adequately educate their patients around opting out and the consequences.
Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant
Women in Health-Care Settings
Excerpt:
Summary
These recommendations for human immunodeficiency virus (HIV) testing are
intended for all health-care providers in the public and private sectors,
including those working in hospital emergency departments, urgent care clinics,
inpatient services, substance abuse treatment clinics, public health clinics,
community clinics, correctional health-care facilities, and primary care
settings. The recommendations address HIV testing in health-care settings only.
They do not modify existing guidelines concerning HIV counseling, testing, and
referral for persons at high risk for HIV who seek or receive HIV testing in
nonclinical settings (e.g., community-based organizations, outreach settings,
or mobile vans). The objectives of these recommendations are to increase HIV
screening of patients, including pregnant women, in health-care settings;
foster earlier detection of HIV infection; identify and counsel persons with
unrecognized HIV infection and link them to clinical and prevention services;
and further reduce perinatal transmission of HIV in the United States. These
revised recommendations update previous recommendations for HIV testing in
health-care settings and for screening of pregnant women (CDC. Recommendations
for HIV testing services for inpatients and outpatients in acute-care hospital
settings. MMWR 1993;42[No. RR-2]:1--10; CDC. Revised guidelines for HIV
counseling, testing, and referral. MMWR 2001;50[No. RR-19]:1--62; and CDC. Revised
recommendations for HIV screening of pregnant women. MMWR 2001;50[No.
RR-19]:63--85).
Major revisions from previously published guidelines are as follows:
For patients in all health-care settings
* HIV screening is recommended for patients in all health-care settings
after the patient is notified that testing will be performed unless the
patient declines (opt-out screening).
* Persons at high risk for HIV infection should be screened for HIV at
least annually.
* Separate written consent for HIV testing should not be required;
general consent for medical care should be considered sufficient to encompass
consent for HIV testing.
* Prevention counseling should not be required with HIV diagnostic
testing or as part of HIV screening programs in health-care settings.
For pregnant women
* HIV screening should be included in the routine panel of prenatal
screening tests for all pregnant women.
* HIV screening is recommended after the patient is notified that
testing will be performed unless the patient declines (opt-out screening).
* Separate written consent for HIV testing should not be required;
general consent for medical care should be considered sufficient to encompass
consent for HIV testing.
* Repeat screening in the third trimester is recommended in certain
jurisdictions with elevated rates of HIV infection among pregnant women.
Continues:
_http://www.cdc.gov/hiv/topics/testing/healthcare/index.htm_
(http://www.cdc.gov/hiv/topics/testing/healthcare/index.htm)
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