In September the CDC revised its HIV testing recommendations. They now recommend that all persons age 13 through 64 be screened for HIV. They also recommend annual screening for "high risk" people. An "Opt Out" model is proposed. I understand this to mean that when routine blood work is to be obtained an HIV test will also be done. The patient will be informed of this and consent for the HIV test will be included in the general consent to blood work. The patient may opt out of the HIV test. This is meant to apply in any medical facility including drug treatment facilities.
Here are my questions:
Are any of you doing this?
If so how are results disclosed and who handles the disclosure?
What measures are taken to avoid a positive result being inferred merely by triggering the disclosure system?
Counselors at my clinic have also raised concerns that patients enrolling in a methadone clinic are "too early" in their recovery to handle learning they have HIV.
Any thoughts?
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2 comments:
I'm commenting on the statement that you made about the counselors at the methadone clinic thinking that some clients were too early in their recovery to deal with an HIV diagnosis potentially. In some cases this may be true, however if a person is already in the process of changing their lifestyle (stopping opiates) they may be motivated to follow up on their healthcare overall. In my experience, giving folks that are early in their recovery something purposeful to do (a lot of appts., etc.) provides a distraction so they are not thinking about using. It can also boost their self esteem, because they are doing something to take control of their life.
I have been doing HCV HIV testing with young IVDU's for many yrs(UCSF dept. med/UFO study) and I feel you must assess if someone is ready to test on a case by case basis not based on where they are in their use or "recovery". Folks here in SF test often b/c there are so many paying studies and sometimes I find that scenario more problematic b/c folks are testing b/c they are dope sick and need cash. I think that testing during the process of managing/cutting down/ recovery is a great time to test even with positives b/c often it gives one a reason for a lifestyle change.
on another note it was great to see Dr barry Zevin on Ch.7/abc last nite speaking about med issues facing homeless folks during the cold snap we are experiencing here in SF.
-Ro
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