Thursday, September 21, 2006

CDC recommends HIV testing for most Americans


AP, ATLANTA - All Americans between the ages of 13 and 64 should be routinely tested for HIV to help catch infections earlier and stop the spread of the deadly virus, federal health recommendations announced Thursday say.

The U.S. Centers for Disease Control and Prevention said HIV testing should become about as common as a cholesterol check. Nearly half of new HIV infections are discovered when doctors are trying to diagnose a sick patient who has come for care, CDC officials said.

“We know that many HIV infected people seek health care and they don’t get tested. And many people are not diagnosed until late in the course of their illness, when they’re already sick with HIV-related conditions,” said Dr. Timothy Mastro, acting director of the CDC’s division of HIV/AIDS prevention.

“By identifying people earlier through a screening program, we’ll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others,” he said.

The announcement was hailed by some HIV patient advocates and health policy experts. They said the guidelines could help end the stigma of HIV testing and lead to needed care for an estimated 250,000 Americans who don’t yet know they have the disease.

“I think it’s an incredible advance. I think it’s courageous on the part of the CDC,” said A. David Paltiel, a health policy expert at the Yale University School of Medicine.

The recommendations aren’t legally binding, but they influence what doctors do and what health insurance programs cover.

Some physicians groups predict the recommendations will be challenging to implement, involving new expenditures of money and time for testing, counseling and revising consent procedures.

Some physicians also question whether there is enough evidence to expand testing beyond high-risk groups, said Dr. Larry Fields, the president of the American Academy of Family Physicians.

“Are doctors going to do it? Probably not,” Fields said.

But the recommendations were endorsed by the American Medical Association, which urged physicians to comply.

“This is important public health strategy to stop the spread of HIV,” Dr. Nancy Nielsen, a Buffalo, N.Y.-based physician who sits on the AMA’s governing board, said in a statement.

No consent form needed

Previously, the CDC recommended routine testing for those at high-risk for catching the virus, such as intravenous drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommends testing for all pregnant women.

Under the new guidelines, patients would be tested for HIV as part of a standard battery of tests they receive when they go for urgent or emergency care, or even during a routine physical.

Patients wouldn’t get tested every year: Repeated, annual testing would only be recommended only for those at high-risk.

There would be no consent form specifically for the HIV test; it would be covered in a clinic or hospital’s standard care consent form. Patients would be allowed to decline the testing.

CDC officials have been working on revised recommendations for about three years, and sought input from more than 100 organizations, including doctors’ associations and HIV patient advocacy groups. The CDC presented planned revisions at a scientific conference in February.

Since then, the CDC has strengthened language on informed consent to make sure that no one is tested without their knowledge, and emphasized the need for doctors to provide information on HIV tests and the meaning of positive and negative results.

© 2006 The Associated Press. All rights reserved.

i heart natalie dee

my new favorite natalie dee comic

Wednesday, September 20, 2006

define sex

in preparation for an activity with my new kids, i've been scouring dictionaries for an inclusive definition of sex and sexuality. unable to find anything satisfying, i turn to you, dear readers.

How do you define "sex"?

How do you define "sexuality"?

i appreciate your participation.

Monday, September 18, 2006

shoot 'em up

My baby sister is going to college. She has her extra long twin sheets, mini refridgerator, and a little something extra. My baby sister has the HPV vaccine.

More specifically, she has the first shot in a series of three that protects against four strands of the human papilloma virus. Similar to the Hep B vaccine, the vaccination is provided in three doses - the second two months after the first and the third six months after the first.

The vaccine, Gardasil, appears to be 100% effective against HPV-16 and HPV-18, the strains that account for 70% of cervical cancers. It is almost as effective with HPV-6 and HPV-11 which cause 90% of genital warts.

The vaccine is approved for women and girls between the ages of 9 and 26. Clinical trials are underway to examine effectiveness with boys and men.

So, what about women over the age of 26? Since HPV is so widespread, is it assumed that those over 26 have been exposed? What about the women over 26 who have managed to avoid exposure through abstinence, safer sex, and luck?

And what of the women who have been exposed to one, but not all four types of HPV the vaccine offers protection against? Say you've had abnormal paps, but not warts, shouldn't you have access to the vaccine to prevent warts in the future, not to mention further abnormal paps from the other strain(s) of HPV?

Now that the vaccine is available, is there access? I know my sister was able to get the hook up in rich white suburbia but what about lower income neighborhoods? Will insurance and medicaid subsidize? Will it be available for free or on the cheap with other vaccinations? Can I ethically advocate vaccination to my teenagers in the Bronx, knowing that the series of shots cost $360?

So many questions. I suppose we will see.