HIV Testing and the Federal Ryan White Grant Program

Sigrid Fry-Revere, Director of Bioethics Studies at the Cato Institute, writes:

The lure of federal dollars may be prompting California lawmakers to consider an ill-advised law to make HIV testing routine. But there's nothing routine about testing for HIV, and legislative efforts to make it more common show little concern for the frankness of the doctor-patient relationship, or the insidious threats to patient privacy.

Assembly member Patty Berg, D-Eureka, introduced a bill in February to encourage routine testing for HIV by eliminating state requirements that patients provide written consent to the procedure. The bill was voted out of the Assembly Appropriations Committee on May 31 and is expected to come to a vote before the full Assembly later this week and possibly as early as today.

No lawmaker admits as much, but the effort may, at least in part, be driven by the new federal Ryan White Grant Program requirements that states provide the names of HIV patients — not just anonymous numbers — to the federal government in order to receive funding for state HIV programs. To maximize numbers, the bill absolves physicians of any need to obtain written consent or do pre-test counseling, and creates a presumption that the test will be done unless the patient specifically objects.

The Ryan White Grant Program seems to be causing a push in state legislatures to test pregnant women for HIV unless they expressly refuse.  See: HIV testing for pregnant women, newborns advances in NJ and Nevada Governor Signs HIV Testing Bill Aimed at Pregnant Women, Infants.

Read more about HIV testing of pregnant women and newborns.