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by
Theodore Dalrymple

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March 16, 2013 - 7:00 am
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For a long time doctors were subject to contradictory imperatives with regard to AIDS. On the one hand they were enjoined to treat it as they would treat any other disease, without animadversion on the way in which the patient had caught it; on the other hand they had, before testing for the presence of HIV, to seek special permission of the patient and to ensure that he or she had had counselling before the test was taken – quite unlike the testing for any other disease, syphilis for example. So AIDS was at the same time a disease like any other and also in a completely different category from all other diseases.

It cannot be said that pre-test counseling is universally popular among patients. There was an Australian clinic that famously offered the test with “guaranteed no counseling” and it did not lack for clients. For quite a number of years, however, HIV-test counselling has provided a living for the kind of people who like to hover around the edges of human catastrophe.

However, the recommendation by the United States Preventive Services Task Force (USPSTF), reported in an article in a recent edition of the New England Journal of Medicine, that henceforth the screening of adults for HIV infection should be routine will, if adopted, put paid to all such pre-test counseling. One cannot counsel scores or hundreds of millions of people.

Seven years ago the USPSTF came to a different conclusion on the question of screening for HIV, believing that the benefits were insufficient to recommend it. Since then, however, evidence has accumulated that treating people early in the course of their infection not only prolongs their life but reduces spread of the infection.

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Top Rated Comments   
Why should I be forced to pay for universal coverage of AIDS under Obamacare?
1 year ago
1 year ago Link To Comment
Screen politicians for syphilis.
1 year ago
1 year ago Link To Comment
All Comments   (9)
All Comments   (9)
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One problem - HIV is not what causes AIDS, and it is questionable whether a thing called "AIDS" even exists.
1 year ago
1 year ago Link To Comment
I got married and a job during the "AIDS-will-be-a-pandemic!" late Eighties, and have likely been AIDS tested more than any other straight, non drug using person (3 times).

It was the law for a while in IL that AIDS testing was required to get a marriage license. After 20 years and millions of dollars, I read they detected AIDS in 26 people.

Because straight people who get married--wait for it--don't have AIDS. Oh well.
1 year ago
1 year ago Link To Comment
As nursing students, we were told to get tested as a baseline in case, during the course of patient care, we were exposed or stuck with a needle and needed to address the fact that our status was negative before this exposure. That has been the ONLY compelling argument I've ever heard for me to be tested for that disease as my life contains none of the behaviors necessary to acquire the virus.

Others may want to consider this, but universal?
1 year ago
1 year ago Link To Comment
The American government should be able to test all Americans at any time for anything. Americans have ceded all their rights and absolute power to the central government in Washington D.C. They should be forced to live in the dystopia that they created. As the old saying goes "you made your bed now lie in it". Americans deserve everything they get after their actions of November 6, 2008. No more protests from Mr. and Mrs. America; you have the government that you have dreamed about and now live in it.
1 year ago
1 year ago Link To Comment
Like other preventive medicine measures, such as PSA testing and mammography, that a few years ago were touted as the solution to lowering medical costs, HIV testing will, as noted by the author, be probably soon be judged as too expensive.
Life saving medical care is now considered optional now that the cost of paying for such essentials as abortion, birth control and sex change operations are so high. You have to have priorities after all.
1 year ago
1 year ago Link To Comment
The proposal described above sounds like a plan to maximize the profits of certain companies. It could be a lot narrower.

Testing should be routine where there is potential to endanger medical personnel. Several years ago, I was hospitalized with pneumonia, arriving in an ambulance at a hospital in Maryland (epicenter of new HIV infections in the US). I am a white female, so not in the highest risk group, but I did arrive through the emergency room.

It took them 5 days to get around to testing me for HIV (negative results). The local CDC rep was hell-bent on getting a lung biopsy for TB before they even thought about HIV.

Dumb.
1 year ago
1 year ago Link To Comment
Why should I be forced to pay for universal coverage of AIDS under Obamacare?
1 year ago
1 year ago Link To Comment
Screen politicians for syphilis.
1 year ago
1 year ago Link To Comment
Screening for psychopaths, sociopaths and malignant narcissists would be much more effective.
1 year ago
1 year ago Link To Comment
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