BTL Editorial August 23, 2007
If we lived in a bias-free world, where no one was ever discriminated against because of any perceived difference, then a completely science-based, epidemiological response to the HIV/AIDS epidemic would look like this: Everyone would be tested, names and addresses of the people who test positive would be published along with all of their sexual partners and/or people with whom they shared their drug works. New infection rates would plummet. In this utopian, bias-free world, reason would always trump irrational fear.
But the real world in which we live is far from bias-free. In this world, and in this moment of our nation's history, differences are often exploited by power-hungry politicians and churned up into fears and prejudices. Immigrants, people of color, gays, transpersons, poor people and people with HIV/AIDS are marked as threats to the general society. People with HIV/AIDS are frequently accused of "deserving" their fate because they behaved badly. Jobs are lost, families shy away, and friends disappear.
In this real, messy world we live in, our society cannot respond to the HIV/AIDS epidemic in a purely scientific way. Instead, we have protections, regulations and laws to protect the identity of people who test positive for HIV so people are not harmed because of their HIV status. Anonymous testing and counseling has been a cornerstone in building trust between a threatened community and the local health departments. Any violation of that trust tears at the delicate fabric that holds together people with HIV/AIDS and the communities within which they live.
That is why it is so disturbing to us that the Ingham County Health Department asks people who test positive for HIV to sign a contract that goes into their permanent file. It shatters the guarantee of anonymity that has been proven to be so effective in encouraging people to come forward and be tested in the first place.
Michigan law states that local health departments must inform HIV positive people of their responsibility to notify any former and future sexual partners of their HIV status, and it is a felony in Michigan for an HIV positive person to have sex with someone without notifying them ahead of time of their HIV status.
But letting people know their responsibilities under the law and having them sign a contract are two very different things. The health departments are supposed to keep test results in files that are identified by numbers only – no names. By inserting a signed contract into each file, the person's identity is easily ascertained by anyone who has access to the files.
We call on the ICHD, and any other Michigan county health department that may be using a similar document, to stop this practice of using signed contracts to inform people of their legal obligations. There are less intrusive and probably more effective ways to encourage people to inform their partners of their HIV status.
In the perfect world we would not have to worry that governmental agencies might misuse the data in those Ingham County files. But in this real world, it is all too real a threat.
