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Test everybody – CDC’s answer to AIDS apathy


If it comes, it might have interesting consequences

Test everybody! Find out if you or I are positive! This is the brave idea whose time has come, according to the CDC and one of its admirers, A. David Paltiel, a health policy expert at the Yale University School of Medicine.

“I think it’s an incredible advance. I think it’s courageous on the part of the CDC,” said A. David Paltiel, a health policy expert at the Yale University School of Medicine.

So down the slippery marketing slope we go with the CDC to the bottom at last, which we welcome with two cheers.

One cheer is for the possibility that more than several superrich and savvy guys’ son or daughter is bound to be positive and then he may pay for a wholesale frontal attack on the NIAID media censorship battlement around the paradigm, or at least a court challenge to the HIV testers to produce an isolated virus, as Martin Kessler suggests in Comments.

The other loud cheer is for the possibility that everybody’s mother and grandmother will prove positive too, just as Dr Harvey Bialy, author and incendiary revolutionary leader of the HIV/AIDS insurgents at the top level of the debate, suspects, as we laid out in our earlier post Ask Mama – a typically novel Bialy initiative, which explained why this research should be done forthwith, by anyone heterosexual who is HIV+ – test your mother and your grandmother immediately, for positively dramatic results.

Federal health officials Thursday recommended regular, routine testing for the AIDS virus for all Americans ages 13 to 64, saying an HIV test should be as common as a cholesterol check.

The U.S. Centers for Disease Control and Prevention guidelines are aimed at preventing the further spread of the disease and getting needed care for an estimated 250,000 Americans who don’t yet know they have it.

“We simply must improve early diagnosis,” said CDC Director Dr. Julie Gerberding.

Nearly half of new HIV infections are discovered when doctors are trying to diagnose a patient who has already grown sick with an HIV-related illness, CDC officials said.

“By identifying people earlier through a screening program, we’ll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others,” said Dr. Timothy Mastro, acting director of the CDC’s division of HIV/AIDS prevention…

The recommendation, if fully implemented, could mean testing for to 100 to 200 million Americans, said Ron Spair, chief financial officer of Pennsylvania-based OraSure Technologies, one of three companies that sell rapid-result HIV tests in the United States.

200 million tests at $15 each, that would be $3 billion.

So is CDC Director Dr. Julie Gerberding (pic) planning an exit to some grateful drug company? Such a thought would never come up in responsible circles. But it is the duty of blogs to mention the unmentionable.

PS: For third loud cheer, see Hank Barnes’ Comment below.

For ref here’s the item, first signalled by McKiernan in Comments today: CDC Backs HIV Test for All Between 13-64

(show)

SF Gate Return to regular view

CDC Backs HIV Test for All Between 13-64

– By MIKE STOBBE, AP Medical Writer

Thursday, September 21, 2006

(09-21) 18:20 PDT ATLANTA (AP) —

Federal health officials Thursday recommended regular, routine testing for the AIDS virus for all Americans ages 13 to 64, saying an HIV test should be as common as a cholesterol check.

The U.S. Centers for Disease Control and Prevention guidelines are aimed at preventing the further spread of the disease and getting needed care for an estimated 250,000 Americans who don’t yet know they have it.

“We simply must improve early diagnosis,” said CDC Director Dr. Julie Gerberding.

Nearly half of new HIV infections are discovered when doctors are trying to diagnose a patient who has already grown sick with an HIV-related illness, CDC officials said.

“By identifying people earlier through a screening program, we’ll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others,” said Dr. Timothy Mastro, acting director of the CDC’s division of HIV/AIDS prevention.

Although some groups raised concerns, the announcement was mostly embraced by health policy experts, doctors and patient advocates.

“I think it’s an incredible advance. I think it’s courageous on the part of the CDC,” said A. David Paltiel, a health policy expert at the Yale University School of Medicine.

The recommendations aren’t legally binding, but they influence what doctors do and what health insurance programs cover.

However, some doctors’ groups predict the recommendations will be challenging to implement, requiring more money and time for testing, counseling and revising consent procedures.

Some physicians also question whether there is enough evidence to expand testing beyond high-risk groups, said Dr. Larry Fields, the president of the American Academy of Family Physicians.

“Are doctors going to do it? Probably not,” Fields said.

But the recommendations were endorsed by the American Medical Association, which urged doctors to comply. The CDC said it’s difficult to predict how many doctors will.

Previously, the CDC recommended routine testing for those at high-risk for catching the virus, such as intravenous drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommended testing for all pregnant women.

Under the new guidelines, patients would be tested for the AIDS virus as part of the standard tests they get when they go for urgent or emergency care, or even during a routine physical.

The CDC recommends everyone get tested at least once, but annual testing is urged only for people at high risk.

Consent for the test would be covered in a clinic or hospital’s standard care consent form. Patients would be allowed to decline the testing. The CDC’s guidelines say no one should be tested without their knowledge.

An American Civil Liberties Union official protested the CDC’s idea of dealing with HIV on standard consent forms, and the agency’s de-emphasis of pre-test counseling.

“By eliminating these safeguards, what they’re calling ‘routine testing’ will in practice be mandatory testing,” said Rose Saxe, a staff attorney with the ACLU AIDS Project.

The cost of the new policy is not clear. A standard HIV test can cost between $2.50 and $8, public health experts say.

New rapid tests cost about $15. If an initial result is positive, confirmatory tests can cost another $50 or more. Treatment for HIV can cost more than $10,000 a year.

WellPoint, the Indianapolis company that owns 14 Blue Cross and Blue Shield plans across the country, has not yet taken a position on the CDC guidelines.

It also hasn’t estimated what it will cost to expand HIV testing for its 34 million members, but it traditionally covers tests recommended by the CDC, said WellPoint spokeswoman Shannon Troughton.

The recommendation, if fully implemented, could mean testing for to 100 to 200 million Americans, said Ron Spair, chief financial officer of Pennsylvania-based OraSure Technologies, one of three companies that sell rapid-result HIV tests in the United States.

The other companies are MedMira Inc. and Trinity Biotech. Standard HIV tests are done through both public health labs and private and commercial labs.

“This certainly expands the rapid HIV testing market,” Spair said.

Identifying more HIV patients will place an added burden on public health programs that pay for such care, some of which are facing potential cuts under a proposal before Congress. But more diagnoses may help win bolstered funding, said John Peebles, an assistant branch chief over HIV programs at the North Carolina Department of Health and Human Resources.

“If you don’t know what you need, you can’t make the argument for resources,” Peebles said.

The CDC has been working on the guidelines for about three years, and got input from more than 100 groups, including doctors’ associations and HIV patient support groups.

___

On the Net:

Centers for Disease Control and Prevention:

www.cdc.gov/mmwr

URL: Test everybody

©2006 Associated Press

5 Responses to “Test everybody – CDC’s answer to AIDS apathy”

  1. noreen martin Says:

    Well, this is an idea whose time has come. It certainly will up the Aids stats tremendously. However, maybe this is a good thing as stated above. When homemakers, grandmothers, church goers, and the elite of society turn up positive then maybe there will be some serious discussions about what is going on. I can only hope that this occurs before more innoncent people are placed on toxic drugs.

  2. jspreen Says:

    Mandatory HIV-testing: The ultimate savior of humanity.

    HIV and Aids celebrate their 25th birthday this Year of the Lord, 2006. Which means they’re grown-ups. Yet many people continue to live with them without even knowing they are there. This must be stopped. Can parents continue to ignore their 25 years old child? Of course not.

    Compared to a flu, a bad cough, headaches, diarrhea, a heart attack, etc, etc, which cannot possibly be ignored by the owner, HIV and Aids can be very silent inhabitants of the host, only to be detected through specially designed testing material. Which, in a certain way, is quite natural because, after all, HIV and Aids being constructions of the human mind, they can only be brought into life if you search for them believing very hard they exist.

    Mandatory HIV testing may be, and even more: should be, considered as the ultimate savior of mankind. Please, allow me to explain, sit still and carefully read the following.

    Although not much is known, nor about the real functioning of tests like Western-Blot, Elisa, PCR, and the like, neither about how results should be interpret, it has become clear over the years that drug addicts and poor and hungry people in general make up the overwhelming majority of the world’s HIV hosts. Practice has also taught us that if testing in itself does almost never enable the tester to be sure of the HIV status of the person being tested, subjective judgment of that person by an experienced tester who can tell, by simply looking at somebody’s face, who and what that person stands for, always provides the desired result.
    If we add to that particular practice the fact that immunity-deficiency is very often simply caused by malnutrition and drug abuse, mandatory testing will make it possible (Finally! Thank God, thank Allah, thank Buddha, thank Shiva, thank every God in the book) to separate the poor, the bad and the ugly from the good.

    AZT, ARVs etc. will do the rest, deliver the world from evil and paradise will be ours.

    Ours, that is, if you’re in it. I’ll be in it for sure. Will you? Look at me for some seconds please… hmm… eyes close together… badly shaved… no ironing… I don’t know, sorry…

    Oh, I forget. This will only work if chemo treatment will become mandatory too. Of course.

    js

    http://www.nightsofarmour.com

  3. Dan Says:

    When homemakers, grandmothers, church goers, and the elite of society turn up positive then maybe there will be some serious discussions about what is going on.

    OR…they’ll continue to play the “risk group” game. All those good, chaste, suburban white folks’ tests will be deemed “false positive”. That would keep the current paradigm in place, but they’d be able to pick up all those “risk group” people that aren’t getting “tested” (due to either apathy or fear of being “positive”, because they’re in a “risk group”).

    It sounds like a potentially win-win situation for the AIDS promoters. The good white folk will stay “negative”, and the bad gays, blacks, hispanics and drug abusers who’ve been slipping out of the net for so long will finally be caught.

  4. kevin Says:

    OR…they’ll continue to play the “risk group” game. All those good, chaste, suburban white folks’ tests will be deemed “false positive”. That would keep the current paradigm in place, but they’d be able to pick up all those “risk group” people that aren’t getting “tested” (due to either apathy or fear of being “positive”, because they’re in a “risk group”).

    This is my biggest fear regarding mandatory testing; however, the optimist in me hopes that there are more than a few competent doctors out there who might question the validity of the tests once they see their clinical inaccurracies. Then again, that may be overly optimistic considering my own non-HIV related treatment woes. Doctors will play a huge role if the masses are ever to have access to the truth about HIV/AIDS. Unfortunately, a doctor’s opinion is readily adopted by the majority of his patients since so few people are willing to take responsibility for the own health status. Not to mention, those same people are usually incapable of critical analysis. On the other hand, mandatory HIV testing has the potential to awaken a lot of people the plight of those who have been branded HIV+. It’s certainly more important to an individual when the brand is placed on him. That is the silver lining.

    One can only hope that as the healthcare industry continues to fail to provide clinical respite for the sick, more people will demand a healthcare system that is somewhat freer from the chains of the financial bottom line. I personally believe that we are going to experience so major macro-economic problems in the good ole US of A and in the very near future. As a result, accountability in all facets of our society will emerge.

  5. HankBarnes Says:

    There may be a silver lining here — to show solidarity and support, the first groups to be tested ought to be:

    1. All gov’t officials of the CDC
    2. All gov’t officials of the FDA
    3. All gov’t officials of WHO
    4. All scientists who have rec’d $$ to research AIDS
    5. All AIDS activists, particularly our friends at TAC/TAG
    6. All medical doctors who have prescribed HAART
    7. All the folks at AMFAR

    Once this wave of testing occurs — all results should be made public, including those who choose to take HAART and those who flush the pills down the toilet — then us normal folks can sit back and assess the situation.

    Just a thought,

    Barnes

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