Politics of Changing HIV Testing Law in California

Issues: In September, 2006, the CDC issued revised recommendations to make HIV testing a routine part of medical care to address the 25% of Americans the CDC estimates are HIV-positive and do not know it. The California State Office of AIDS estimates that 30,000-40,000 Californians are unaware they are HIV-positive and, therefore, are not receiving appropriate HIV treatment and possibly jeopardizing their own health and that of their sex and drug-using partners. The CDC and other health professionals believe that one major barrier to HIV testing is burdensome consent and pre-test counseling requirements, which the new guidelines attempt to modify. Description: The San Francisco AIDS Foundation (SFAF) is interested in expanding testing rates in San Francisco and California. Data indicate that California's laws governing consent for HIV testing are sufficiently burdensome that many physicians do not offer tests to their patients. SFAF, in collaboration with an alliance of state organizations, is developing an evidence-based policy approach and legislative strategy to modify existing statute with the aim of increasing HIV testing while protecting the rights of patients. Lessons Learned: We will present the challenges and successes we have had in this process, including reaching consensus among alliance members and other stakeholders (civil liberties, HIV/AIDS, and medical organizations) about specific bill language, obtaining data to inform our legislative strategy, and finding the right sponsor to carry the bill. Recommendations: As this effort is ongoing, this session will be an opportunity to share lessons learned and to strategize with colleagues from different locales.