Tom Coburn’s war on people with HIV
So, Senator Tom Coburn, of bathroom storming lesbians in Southeastern Oklahoma fame, is at it again. This time he’s giving us the choice of pulling $60 million dollars of prevention money out of the fight on HIV/AIDS or gutting the right of informed consent and the availability of pre-test counseling across the country. So, one might ask, how did Senator Coburn get to do this? He insisted on an amendment to the recently enacted Ryan White Treatment “Modernization” Act (quotations mine!) that sets aside $60 million dollars over the life of the Act for “prevention counseling, treatment of newborns exposed to HIV/AIDS, treatment of mothers infected with HIV/AIDS, and costs associated with linking those diagnosed with HIV/AIDS to care and treatment for HIV/AIDS.” These monies are to be taken from the CDC’s HIV Prevention line item. So what’s wrong with that?
This. The money is only available to states that do not provide pre-test counseling and deny informed consent for pregnant women, clients of sexually transmitted disease clinics or clients of substance abuse treatment centers. Or, states can opt to remove the parents from the picture and impose universal newborn HIV testing. States don’t have to do all of this—they merely have to choose which populations to disenfranchise.
But it doesn’t appear that any states currently qualify for the funds—it’s those pesky laws about informed consent and adequate counseling that most states still have that gets in the way. If no states qualify, instead of being made available for other HIV prevention efforts, the funds revert back to the Treasury–60 million dollars less to stop the spread of HIV. So the push is to repeal the laws providing for informed consent and counseling.
This move to deny people the right to informed consent and adequate counseling coincides with the perception that HIV/AIDS is a disease of African-Americans. A recent book notes that legal constraints, such as those protecting the right of informed consent, that were not applied when the disease was believed to affect primarily white men have been “vigorously applied” to African-Americans.
As the populations affected by HIV have gotten darker and poorer, traditional measures such as counseling and informed consent for testing have been challenged. Given its deplorable track record, the African American community is rightfully mistrustful of the medical establishment. But, and this is the crux of the problem, can we really believe that creating a more coercive, punitive care system will get more African Americans to enter care? And why are we allowing that question to be answered by a Senator who tilts at boogeywomen in bathrooms?
