ACLU pushes for HIV confidentiality

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The American Civil Liberties Union (ACLU) sent a letter to the San Francisco Department of Public Health this week demanding that the San Francisco City Clinic stop misleading people being tested for HIV.

A new state law that went into effect on April 17 2006 requires all health care providers and laboratories to report names of individuals with HIV to the local health department, yet the City Clinic run by the San Francisco Department of Public Health has been telling people taking the HIV test that their names would not be reported to the state if they test positive.

The ACLU is demanding that the Department of Public Health not report the names of those deceived.

“Being diagnosed with HIV still comes with huge consequences,” said Tamara Lange, a senior staff attorney with the ACLU of Northern California and the ACLU AIDs Project. “If the Department of Public Health really wants to encourage people to find out their status and get treatment, the last thing they should be doing is giving people false information. This is exactly the kind of deception that makes people scared of getting tested.”

The ACLU became aware of the problem after a local resident went to the City Clinic, one of the busiest clinics in San Francisco, to be tested on May 26 2006. Prior to being administered the test, the resident was asked to sign a consent form that stated that his name would not be reported if he turned out to be positive.

The resident signed the form and went ahead with the testing. He later notified the ACLU because he was aware of the new law requiring names reporting of people who test positive. The resident, who prefers to remain anonymous, also alerted Dr Jeffrey Klausner of the San Francisco Department of Public Health. But, as of today, the City Clinic website still says that the names of those testing positive for HIV will not be turned over to the state.

“California law requires that people can only be tested for HIV if they give their written informed consent, except under very limited circumstances. This law recognises that testing positive for HIV remains a life-changing diagnosis, and that government and health care providers have an obligation to ensure that anyone seeking an HIV test can make a fully informed decision to be tested,” said Rose Saxe, a staff attorney with the ACLU AIDS Project.

Ms Saxe noted that in light of the new law requiring health care providers and laboratories to report the names of individuals testing positive, people should also be reminded that anonymous testing remains available in San Francisco and throughout California. Under anonymous testing, names are never reported to the state.

The letter sent by the ACLU to the Department of Public Health demands that the department agree that it will immediately begin to give people accurate information about HIV testing, and that it will not turn over to the state the names of any HIV positive person who relied on the guarantee of confidentiality in the City Clinic’s consent form.

The use of the inaccurate consent form by the City Clinic comes at a time when public health officials around the country are pushing for more relaxed informed consent rules. Earlier in the epidemic, public health officials recognized that in order to build public trust it was important for people to know that they were being tested and to understand the consequences of being diagnosed with HIV and therefore required those being tested to sign a written consent form. Some public health officials are now balking at the consent forms claiming they are too time consuming.

“The actions of City Clinic should serve as a wake up call to public health officials on the importance of being honest with the public. You can’t expect people to trust the government when the government proves that it isn’t to be trusted. Safeguards, like requiring written informed consent, were put in place to protect people. But as the City Clinic’s actions here illustrate so clearly, those safeguards are still necessary to maintain the public trust which is critical to getting people tested in the first place,” added Lange.

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