This Week in HIV/AIDS News

• Washington, D.C., Officials Urge ‘Opt-Out’ HIV Testing, Discuss Prevention City council members and health officials in Washington, D.C., are asking “health care providers to make HIV testing part of routine patient treatment,” the Washington Examiner reports. According to the Examiner, “Health officials want all medical providers in the city to implement an ‘opt-out’ policy in which patients would be tested automatically for HIV unless they choose to refuse the test.” Shannon Hader, director of the HIV/AIDS Administration, said 70 percent of district residents newly diagnosed with HIV had been to a medical provider in the previous 12 months and were not offered HIV testing. “Health officials also are working to improve condom access and distribution, one the most critical preventative measures in combating HIV,” and “the city has asked for $4 million from [CDC] to support a campaign aimed at encouraging people to get tested and practice safe sex,” the Examiner reports (7/9).

• Scientists Examine HIV’s Affect On Immune System A study by researchers from Duke University and the University of North Carolina-Chapel Hill and published in PLoS Medicine has found that upon infection “three lines of attack by the immune system are quickly neutralized by HIV,” findings they hope “will provide a better understanding of how to develop a vaccine to protect against the virus,” the Raleigh News & Observer reports. The study, lead by Duke’s Barton Haynes, showed that HIV, “once considered a slow if stealthy invader, actually works incredibly fast at disarming key immune fighters in the body.” Haynes said scientists still have a difficult task in developing a vaccine, adding, “It would have to be different than any other vaccine made” (Avery, 7/7).

• Study Examines ‘Elite’ Group Of HIV-Positive People Who Appear ‘Protected’ From Developing AIDS An international contingent of nearly 500 researchers and physicians are taking part in the International HIV Controllers Study, which is examining “the phenomenon,” in which certain people living with HIV seem “somehow protected from AIDS,” the Washington Post reports. Fewer “than one in every 300 cases, or perhaps 5,000 of the more than 1 million infected Americans” living with HIV are deemed “‘elite controllers’ because their ability to combat the virus puts them in exceptional company among infected individuals,” according to the Post. The article states, “No one knows how their bodies keep AIDS at bay. Are their immune systems exceptionally strong and effective? Do they possess some genetic trait that protects them? Or does a combination of still-unknown factors set them apart?” Researchers anticipate that studying the T cell levels — which helps determine the progression to AIDS — of the elite controllers, will enable them “to uncover what shields these rare few from AIDS. And perhaps in the process they’ll find a way to safeguard everyone else as well,” the Post reports (Slack, 7/7).

• Editorial, Opinion Piece Discuss Issues Related To Routine HIV Testing A recent directive to streamline the HIV testing consent process in Massachusetts as well as consent forms “no longer hav[ing] to accompany test specimens to the lab,” are bringing “the state closer to a CDC recommendation that clinicians provide HIV screening on an opt-out basis,” according to a Boston Globe editorial. “The opt-out provision is at the heart” of legislation sponsored by state Sen. Patricia Jehlen (D) that would end the state’s requirement of written consent for HIV testing “and instead have healthcare providers inform patients verbally that the test is planned but that they can decline it,” the editorial states, adding, “The Jehlen bill would help destigmatize HIV testing itself” (7/6). Separately, an opinion piece in the Detroit Free Press — by David Share, medical director of the Corner Health Center and senior associate medical director of health care quality at Blue Cross Blue Shield of Michigan and Sandro Cinti, a clinical assistant professor in the Department of Internal Medicine at the University of Michigan-Ann Arbor — supports a Michigan bill (HB 4583) that would eliminate the written informed consent requirement in that state and replace it with a pamphlet and an informational opt-out form. Share and Cinti write of the current requirements, “These extraordinary precautions provide no protection, are not needed, and distract patients and health care professionals from other services and treatments that have the potential to improve patients’ well-being,” adding,”Routine HIV testing should be encouraged for early diagnosis and treatment of HIV infection” (Share/Cinti, 7/2).

“Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report , search the archives, and sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.”