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Home HIV Testing

August 25, 1994

I strongly disagree with your support of a home HIV test (editorial, Aug. 7). A home HIV test is not analogous to a home pregnancy test. It is analogous to a home cancer test. I can't imagine any responsible care provider telling people they have a potentially terminal disease by mail or over the phone. I can't imagine relying on a printed package insert of an 800 number to ensure that an HIV-positive person is immediately linked with the treatment and services he or she desperately needs.

At the Los Angeles Free Clinic, we provide individual counseling before each test. Our counselors are trained to identify people who may be suicidal or have other mental health needs. After a test, we are able to respond to people immediately and individually. We can assess needs on the spot, and make referrals for treatment and counseling.

Our counselors also play a tremendously important role in educating people about staying safe, and offering suggestions and support for safer behavior. We have peer counselors who can speak directly to adolescents--a group at increasing risk for HIV--in a way that a printed brochure or an 800 operator simply cannot.

When someone tests positive for HIV, they need to know there is help, and there is hope. A home HIV test just reinforces the shame and isolation that accompany HIV.

MARY L. RAINWATER

Executive Director, Los Angeles Free Clinic

* I believe that we cannot stand in the way of a new technology that has the potential to extend and save lives. At our clinics and hospices, we see firsthand the human toll that delayed treatment for HIV is taking. Among the 2,000 clients at AIDS Healthcare Foundation's clinics, 1,200 (60%) are below 200 T-cells and have already experienced severe immune compromise.

Half of all people with HIV in Los Angeles are tested for the first time when they are hospitalized or as a result of HIV symptoms. In Los Angeles, as across the country, fewer than 50% of the people who are HIV positive know it. In Los Angeles County, Centers for Disease Control-sponsored testing programs are the least successful of any in the country. With a 1.3% rate of detection, our testing program has the lowest rate of sero-positivity and we do the fewest tests. Often, many people do not return to get their results.

The testing program is not working. The people who are most in need of testing are not being tested. Testing sites are clogged with lower-risk individuals. I support HIV home-collection testing because I believe it provides an alternative that will encourage more people to be tested.

I share the concern of other community activists about the psychological distress that a positive test brings. However, I believe the direct access counseling program guarantees a very high quality of telephone counseling and referral services. This experience is one far superior to most counseling and referral services that are currently being provided to HIV-positive persons.

MICHAEL WEINSTEIN, President

AIDS Healthcare Foundation

Los Angeles

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