Eliminating Rhode Island's HIV test signature requirement would boost prevention, treatment efforts

Rhode Island's legislature currently is considering a bill (H.B. 5415) that would eliminate a requirement that a person sign his or her name before undergoing an HIV test, which "would essentially make getting an HIV test more like getting any other medical test," Brian Alverson, assistant pediatrics professor at Brown University's Alpert Medical School and head of the Section of Pediatric Hospitalists at Hasbro Children's Hospital, writes in a Providence Journal opinion piece.

According to Alverson, although opponents contend that the bill "would lead to more people being tested against their will," the "problem ... is that people who need the test aren't getting it." He continues that the "evidence is overwhelming that eliminating the signature would decrease the burden of HIV in Rhode Island" because "[w]hen people know their HIV status, they are much less likely to spread the disease."

Although HIV clinics typically do not encounter difficulty obtaining signatures for tests, some people do not receive HIV screenings until they develop late-onset disease "because in hospitals, emergency rooms and primary care offices, getting the form and signature are bothersome and an impediment to testing," Alverson writes. He continues that if physicians detect HIV early, "one can expect to live well into old age." However, testing delays "incur a grave risk of death" and can lead to the development of AIDS, he writes.

According to Alverson, Rhode Island three years ago passed a law eliminating the signature requirement for HIV tests for pregnant women. Alverson writes that "[t]his simple change to the law works" because HIV testing rates for pregnant women rose from 53% to 93% and Rhode Island went from having the sixth highest rate of HIV-positive infants to having zero new cases. In addition, the bill not only prevented HIV among infants, it also saved Rhode Island about $5 million in health care expenditures, Alverson writes.

According to Alverson, Rhode Island has reported about 150 new HIV cases since the state General Assembly last year delayed the current bill for further consideration. He continues, "There is more HIV in Rhode Island now than ever before, and we have to move to stop this horrible disease. We cannot afford to put this off another year." Alverson concludes, "Clearly, the legislature must pass this bill" (Alverson, Providence Journal, 5/1).