| March 04, 2010 | ||||
In Today's In-Brief:
IN HONOR OF WOMEN & GIRLS’ HIV AWARENESS DAY: ALL WOMEN SHOULD HAVE ACCESS TO HIV TESTING HIV testing is understood to be a cornerstone in effective HIV prevention policy. Yet too many women are not tested because they or their healthcare provider do not perceive that they are “at risk.” HIV testing should be routine for all women, as it is during pregnancy. To achieve this goal, the federal and state governments should provide incentives for increased HIV testing, while maintaining important patient protections in the testing process. “In order to increase testing rates, health care providers must be reimbursed by insurance providers for all HIV tests, regardless of the perceived risk of the person being tested,” says HIV Law Project’s Executive Director, Tracy Welsh. Yet in most parts of the country, providers are only reimbursed for HIV tests given to patients who fall within established categories of risk for HIV. This disproportionately negatively impacts women. While 80% of women who test positive contracted HIV from a male sexual partner, heterosexual sex does not fall within established reimbursable risk categories. Rather, for heterosexual women, risk is assessed only based on known risk factors of their partner – a risk many women are unable to assess accurately. Some creative solutions to this problem have been put forward. In 2008, California passed landmark legislation that required all health insurers, public and private, to reimburse routine HIV screening. Other states should follow suit. Also, United States Senator Gillibrand of New York has introduced a bill (S. 1446) that would offer financial incentives to Medicaid providers to screen for HIV. Unfortunately this bill links reimbursement with opt-out style HIV testing, which is contrary to voluntary opt-in testing currently required in NYS. “As we push to increase testing rates, particularly among women and girls, we must be sure that we do not sacrifice individual rights,” says Ms. Welsh. Testing schemas that require a provider to offer an HIV test create the foundation of a strong patient-provider relationship, while those that require a provider to perform an HIV test (even where the patient has the opportunity to decline the test) risk patient confusion, fear, and alienation. If providers are given incentives to encourage routine HIV testing of all their patients, particularly women, the vast majority of women will accept testing as has been shown in the prenatal context in NYS. When women know their HIV status, they can be connected with appropriate care and services, so that they can continue to care for themselves and their families. HIV Law Project believes that all people deserve the same rights, including the right to live with dignity and respect, the right to be treated as equal members of society, and the right to have their basic human needs fulfilled. These fundamental rights are elusive for many people living with HIV/AIDS. Through innovative legal services and advocacy programs, HIV Law Project fights for the rights of the most underserved people living with HIV/AIDS. NYC'S ONLY DETENTION FACILITY CLOSES, STRANDING UNKNOWN NUMBERS OF HIV+ DETAINEES On February 27, 2010, New York City's only facility for detained immigrants was scheduled to close. The Varick Street Detention Facility, located at the corner of Varick and Houston streets in the West Village, housed approximately 300 male immigrants along with a small immigration court where they could petition for relief from removal - although the judges assigned to the facility grant notoriously few applications. The facility, which closed in 2001 and reopened again in 2008, held a diversity of noncitizens who violated the federal immigration laws, including lawful permanent residents, those who overstayed valid visas, and those who had entered without inspection at land and sea borders. Some of the detained found themselves in removal proceedings following the completion of sentences for both non-violent and violent criminal offenses. Click here to read the NYC Bar Justice Center Report. In recent years, detainees filed complaints about their conditions of confinement, leading to a series of articles by Nina Bernstein of the New York Times in which she profiled the problems in local detention facilities overseen by the Immigration and Customs Enforcement (ICE), an agency of the Department of Homeland Security. In January 2010, ICE announced that the Varick Street facility would be closed for good and that detainees would be transferred to Hudson County Jail, part of a network of county jails in northern New Jersey contracted by ICE to house immigration law violators along with local criminals. On February 12, ICE issued a statement confirming that it would continue to arrange meetings between detainees and their local attorneys when they were brought to the facility for their hearings before the immigration court. ICE later rejected requests by local advocates to arrange alternatives to detention for eligible detainees. On February 24, 2010, Nina Bernstein reported that detainees with acute medical needs would be kept at the Varick Street facility until other arrangements could be made [insert link to "Sick Detainees Complicate Plans to Close Facility"]. Although the facility was originally meant for only short term detentions, some were always held longer when county jails refused to accept detainees with serious medical or mental health problems. While Varick Street was open, detainees who self-reported as HIV positive were provided regular checkups at St. Vincent's Medical Center. Even with access to New York City's hospitals, however, some detainees continued to suffer neglect, and one was recently deported while in acute pain from cancer for which he was refused treatment. In 1999, a Dominican man died of untreated pneumonia at the facility. According to Ms. Bernstein and various other reports, there have been a number of needless deaths and violations of basic standards of care. HIV Law Project is extremely concerned about the fate of HIV positive detainees who will be even further separated from ongoing treatment and care as a result of Varick Street's closure. The "current crisis facing sick detainees with nowhere to go illustrates the lack of foresight and planning that plagues the detention system as a whole," said Cristina Velez, Staff Attorney at HIV Law Project. HIV Law Project is actively engaged in developing policy recommendations regarding the treatment of HIV positive detainees and is looking to create partnerships with its supporters in the legal and policy communities. *HIV Law Project is a 501(c)(3) organization. Donations are 100% tax-deductible. BE SURE TO RECEIVE OUR IN-BRIEF EMAILS. MAKE HIV LAW PROJECT YOUR BUDDY! Some Internet Service Providers like AOL, Yahoo! and Hotmail use
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