Sacramento Bee

By Aurelio Rojas - Bee Capitol Bureau
Published 12:00 am PDT Wednesday, September 26, 2007

A year after federal health authorities recommended HIV testing as part of routine medical care, Gov. Arnold Schwarzenegger is considering signing legislation that would implement that policy in California.

Assembly Bill 682 by Assemblywoman Patty Berg, D-Eureka, cleared the Legislature with nearly unanimous bipartisan support.

"My bill makes HIV screening a routine part of your medical exam, just like screening for cholesterol and diabetes," Berg said Tuesday during a conference call with reporters.

Currently, patients must provide written consent to have their blood tested for HIV, the virus that causes AIDS.

Under AB 682, patients 13 to 64 would have such tests done routinely by doctors unless they or their caretaker declines the procedure. The bill is backed by the 35,000-physician California Medical Association.

Berg and other members of the Test for Life California coalition are encouraging everyone to be tested. They cite estimates by California health officials that about 40,000 people in the state don't know they're infected.

"It's been a particular concern in minority communities where we're still seeing the high prevalence of HIV/AIDS," said Dr. Gary Puckrein, president and chief executive officer of the National Minority Quality Forum.

Donna Wood, vice president of the Sacramento chapter of the National Coalition of 100 Black Women, said of the estimated 1.2 million people in the United States with HIV/AIDS, nearly half are African Americans.

"In California alone, while we are only 7 percent of the population, African Americans account for 20 percent of new AIDS patients," Wood said.

Studies have shown people of color are far more likely to learn of their HIV infections less than a year before they develop AIDS -- too late, Wood said, to get effective treatment.

"At a time when more treatment is available and people with HIV/AIDs can live longer, healthy lives, fewer African Americans as well as other citizens are not getting tested," Wood said. "This must be reversed."

Michael Weinstein, president of the AIDS Healthcare Foundation, said AB 682 "is part of a long road toward normalizing the treatment of HIV."

As HIV testing began nationwide in the 1980s, many people lost their jobs and homes when word of their HIV status leaked out. Lawmakers in many states, including California, passed legislation to protect the anonymity of each person's test results.

California kept that practice until April 2006, when it became one of the last states to adopt the federal standard of allowing name-based reporting of HIV infections.

A year ago today, the federal Centers for Disease Control and Prevention recommended HIV screening as part of routine medical care -- such as when patients come in for an annual physical or a prescription refill.

"The CDC guidelines were important steps forward, but 25 states covering most of the HIV-infected in this country had provisions in law that prevented its application," Weinstein said.

These states required written informed consent, which Weinstein said is a big barrier in emergency rooms and other fast-paced medical settings.

Weinstein said doctors already complain of too much paperwork. The added burden of getting written consent in such situations, he said, is often "impossible" and far outweighed by the benefits of HIV screening.

Noting the CDC estimates that between 50 percent and 70 percent of new infections "occur via a person who doesn't know they are infected with HIV," Weinstein said, "When people know, they will act to protect their partners."

State Sen. Dennis Hollingsworth, R-Temecula, was the only member of the Legislature to vote against AB 682.

A spokesman for Hollingsworth said the senator believes that without informed consent, patients will not get all the information they need to make a decision.

A spokeswoman for Schwarzenegger said the governor has not decided whether to sign the bill, but Weinstein expressed optimism.

"After the governor signs this bill ... we're going to need to get insurers to cover the costs of tests," he said.

A standard HIV test costs as little as $15, Weinstein said. Insurers typically pay the cost when the test is ordered by a doctor.

But Weinstein said insurers typically bundle services they will cover as part of routine medical care. His coalition's goal is to include HIV screening.

Teresa Stark, a representative of the California Medical Association, said physicians believe HIV screening is "the next step in the fight against HIV and AIDS."

"By preventing the transmission and extending (an) individual's life and productivity in the workplace, obviously the cost savings are pretty clear," Stark said.