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Testing for HIV/AIDS

 
 
littlek
 
Reply Thu 10 Mar, 2005 11:31 pm
NPR had a show on today about a guy who proposed that people who knowingly passed HIV/AIDS on to their partners should be held financially responsible for their actions. He caused quite a stir with his thoughts (he's gay himself) and there was some heated discussion on the air.

One point keeps ringing in my ears: we don't have regular testing for HIV/AIDS here in America. Why not? It seems that many cases of the virus are undetected before the carrier gets sick - all that time he/she is able to pass the virus along. Wouldn't regular testing at annual office visits (once every 1-3 years) help bring the number of new cases way down?
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Type: Discussion • Score: 1 • Views: 965 • Replies: 16
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littlek
 
  1  
Reply Thu 10 Mar, 2005 11:36 pm
aha... from the MSNBC website (from feb 9 2005):

Quote:
The other study, by Yale and Harvard researchers, found that testing people every three to five years would be cost-effective for all but the lowest-risk people, such as those who are celibate or are in monogamous heterosexual relationships. And even for those people, one-time testing was found to be cost-effective.

Nationwide, about 40,000 new HIV infections occur each year. An estimated 950,000 people are infected with the virus, but about 280,000 of them don't know it.
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roger
 
  1  
Reply Thu 10 Mar, 2005 11:39 pm
Maybe. Yet, while people with HIV cover the whole spectrum, not all are necessarily the most sexually responsible segment of the population.

Is the testing proposed as a mandatory proposition? Who pays, in that case?

can't sleep, littlek?
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Debra Law
 
  1  
Reply Thu 10 Mar, 2005 11:53 pm
Re: Testing for HIV/AIDS
littlek wrote:
NPR had a show on today about a guy who proposed that people who knowingly passed HIV/AIDS on to their partners should be held financially responsible for their actions. He caused quite a stir with his thoughts (he's gay himself) and there was some heated discussion on the air.


Not only should they be held financially responsible for civil damages, they should be held criminally responsible.

The only problem is collecting a civil judgment for money once one is obtained. Unless the tortfeasor has substantial money or other assets, a civil judgment might not be worth the money it's written on.
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cicerone imposter
 
  1  
Reply Thu 10 Mar, 2005 11:54 pm
It was some years ago, but I thought a partner infecting another was tantamount to a crime/murder. Things may have changed with the improvement in drug treatment, but I read there's a new strain that will kill within one month rather than years.
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roger
 
  1  
Reply Fri 11 Mar, 2005 12:07 am
In some cases, new treatments prolong the ability to spread the disease.

Sounds like murder to me, too.
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Debra Law
 
  1  
Reply Fri 11 Mar, 2005 01:46 am
Rock Hudson's lover, Marc Christian, successfully sued Hudson's estate. Rock Hudson knew he had AIDS but intentionally failed to inform Christian causing Christian emotional distress when he finally learned the truth. I believe Christian won a verdict of over $14 million and the court reduced the award to $5 million.
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Walter Hinteler
 
  1  
Reply Fri 11 Mar, 2005 01:51 am
Well, people who pass knowingling HIV to someelse, are hold responsible for that here (At least by criminal law, but I'm sure, health security agencies are trying to get the money back from them as well.)

However, what about someone who's got a flu - and still goes outsite, infecting other?

What about the other sexual diseases?
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ossobuco
 
  1  
Reply Fri 11 Mar, 2005 02:17 am
Many years ago and far away, I was a lowly bacteriology student. Back then all sorts of stuff had to be annotated to the county health department or the state, mostly having to do with tuberulosis or syphilis.

which hit me in the tummy many years later when I was past being a student by many years and was out the field I worked in, immunology, and working in landscape architecture. I went to Jules Stein eye clinic to get my eyeglass prescription but also to find out if I had retinitis pigmentosa, as I suspected, if only from RP ads in magazines, but also since I had never been able to see at night and tended to miss chairs and steps which others didn't.

So... the resident who checked me doubted I had rp, but wondered first about glaucoma (no) and then noticed I tested poorly in some chart with yellow, like the coffee ad,
and then kept looking. Finally after about twenty minutes of looking he found telltale rp deposits near capillaries.. much more of a surprise to him than me, since I was the one who tripped on steps at night. Still, they had to clear me for possible background and did some tests. Syphilis can cause night blindness, I gather.

Yes, I came back positive 1+ for a fluoroscein syph test, forget the name now, perhaps FTA.

A nurse called me in the middle of an land arch meeting, imagine my delight, since I asked not to be called at work. Said I had to go to the Infectious Disease Clinic as soon as possible.

Hmmm.
<did this mean I would have to report all past sexual contacts????? gag city?????>

Aside from losing my mind re who I might have to call, I also
considered that it was unlikely I was really positive. I happened to used to be an immunology tech who ran fluorescent antibody tests, and knew that 1+ has more or less meaning, mostly meaningful when on the way down from 4+. A 1+ can be a random thing. Still, even knowing this, t'was a gripper.

So, I called the head of infectious disease, who was a friend of my boss in immunology, and told him the details and he said, in essence, bah, this is not serious, ask them to run a
whatsit. All these years later, I forget the name of the whatsit, maybe Treponema pallidum antibody test, but whatever it was, it was less usual, somewhat more complicated to do. (I used to know how to distinguish these, some time ago.)

So I told this to the resident, who ordered it, and yes, I was neg. Sheesh, my life had roiled before mine eyes, re contacting contacts.

Anyway, contacting contacts was serious in my day.
Aside from the lesson of knowing who to know re knowing stuff.
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ossobuco
 
  1  
Reply Fri 11 Mar, 2005 02:25 am
So, I didn't mean to not talk about fiscal responsibility, but back then, the trick was to follow who could infect whom, to stop the epidemic..

I guess money is the inevitable followup.
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Instigate
 
  1  
Reply Fri 11 Mar, 2005 02:42 am
cicerone imposter wrote:
It was some years ago, but I thought a partner infecting another was tantamount to a crime/murder. Things may have changed with the improvement in drug treatment, but I read there's a new strain that will kill within one month rather than years.


This new strain is disadvantageous to the virus because it kills the host quicker and leaves him less time to spread the virus. It wont last.
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raspberrian
 
  1  
Reply Fri 11 Mar, 2005 02:54 am
OMG!!! I was listening to same show today. I like listening to NPR. I think that they should be obligated to assist someone with their prescriptions. One has to have the integrity and take responsibility for the actions...as for anything. Like the guy who has kept confidential records since the 70's or 80's I believe, said "You cannot point to them and tell them what they did wrong, but what they can do about it and take that responsibility." You don't want to make them feel bad or run them away because they knew that they had HIV/AIDS when they exchanged fluids with another individual.
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littlek
 
  1  
Reply Fri 11 Mar, 2005 11:01 pm
Roger - it is indeed a felony (according to the people on NPR). But, no one gets tried unless, as the speaker said, it's a black man who knowingly infected white women. Interesting, eh? Anyway..... if you could prove it, you could prosecute someone for knowingily infecting you - is that right Debra_Law?

Osso - there is still no federal law about contacting past sexual contacts in HIV/AIDS situations.

All I know is that there needs to be some sort of severe repurcusions to knowingly infecting people with HIV. That coupled with automatic testing would bring the infection rate way down, it would seem to me.
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JPB
 
  1  
Reply Sun 13 Mar, 2005 07:25 pm
Hi littlek, I've been gone all weekend and I'll give you a more detailed answer tomorrow but routine screening for HIV was implemented by many states in the late 80s, early 90s and then dropped as ineffective. There are many new cases of HIV anually but they tend to run in pockets or clusters. Routine testing, via pre-marital screening, determined that the cost of testing far outwieghed the benefit of detecting a few cases in the random population. Each test costs $20.00 to $50.00 depending on where it's done. Each positive screening result needs to be confirmed with far more expensive and more sensitive confirmatory tests (as Osso's story described, false positive screening results are not uncommon). It is difficult and likely unethical to implement required routine screening in the high risk groups and too costly to implement it in the general population. Mr B and I were married during the time that premarital screening was required in IL (1989). The requirement was dropped here in 1990 and was dropped nationwide during the next few years.
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littlek
 
  1  
Reply Sun 13 Mar, 2005 08:43 pm
Lovely
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cicerone imposter
 
  1  
Reply Sun 13 Mar, 2005 09:09 pm
"Till death do us part" has a whole new meaning.
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Noddy24
 
  1  
Reply Sun 13 Mar, 2005 10:48 pm
Even with testing, there is an incubation period for the AID's virus.

Bottom line? Be very careful about your love life. I'm against HIV and AID's ,but I'm not sure that I'd want to give the government full responsibility for protecting me.
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