Date published: 2007/08/11
The BBC says:
Too many people are refusing HIV tests at sex health clinics - and a key government target could be missed as a result, says an Aids charity.
The target aimed to halve the number of people whose HIV infection is missed when they visit a sexual health clinic for another reason.
The National Aids Trust said that making an HIV test automatic could solve the problem.
The Department of Health said it was reviewing policy on testing.
Many people who have contracted HIV remain unaware of this, as it may be some time before symptoms begin to appear - it is estimated that a third of HIV-positive men and women in the UK don't know they have the virus.
However, during this period, they may be able to pass the virus on to others through unprotected sex or sharing drug needles.
The government's National Strategy for Sexual Health pledged, by the end of this year, to cut by 50% the proportion of people infected with HIV who remain unaware of their infection even after a visit to a sexual health clinic for another reason.
Experts can work this out because the Health Protection Agency tests random, anonymous blood samples, even where the patient has refused an HIV test, providing a figure for the underlying rate of infection among people visiting clinics.
In 2001, 55% of gay men with undiagnosed HIV visited a sexual health clinic, and left without a diagnosis.
In the latest figures taken in 2005, this had fallen to 43%, well short of the target of 27.5%.
The target is likely to be met among heterosexual patients, with the figure falling from 48% in 2001 to 27% by the end of 2005.
At the moment while people are offered and encouraged to take an HIV test, unless they actively "opt in", the test won't take place.
The National Aids Trust now wants an "opt-out" system for HIV testing, with the presumption that the test will go ahead unless the patient actively refuses.
If people are "offered and encouraged to take an HIV test" and refusing, then that should be the end of the story. If the clinics were honest, then the current pro-active opt-in system should be no different than an opt-out system where the patients were also "offered and encouraged to take an HIV test". You give patients an informed choice and they say yes or no. So what the National Aids Trust seems to be relying on is that clinics in future would either surreptitiously not mention to patients that they are doing an HIV test, or perhaps instead forcefully bully patients into acquiescence. So the proposed policy is fundamentally dishonest in intent. It might even discourage people from attending sex clinics.
It is also ridiculous for such a policy to be introduced just because some random government target is not being met. And note the BBC completely distorts the real impact of the proposed change by just quoting how many people with HIV refuse a test, but not stating how many people who visit a sex clinic have HIV. That figure is probably quite low, so once again the majority is having dreadful policies foisted on them allegedly in order to protect some small minority. This figure would also determine how much money is being wasted on null tests in order to find the needle in the haystack.
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