Florida House Bill 321 is bringing HIV testing out of the shadows.
Signed into law by Gov. Rick Scott on June 10 and put into effect on July 1, HB 321 streamlines the process of HIV testing in medical settings and establishes it as routine by requiring patients to explicitly opt out of screening, rather than opting in.
“Before this bill, people sometimes were asked (by their doctors), ‘Do you want to be tested for HIV?’ and interpreted it as an indictment that they had been involved in risky behavior,” said Florida Sen. Geraldine Thompson (D), who co-sponsored HB 321.
Consultations thereafter look like this: Weight/height? Check. Blood pressure? Check. Blood work for heart disease, cholesterol — and HIV?
According to Michael Ruppal, executive director of the AIDS Institute, HIV’s taboo past has faded but not disappeared.
The stigma that surrounds the disease contributes to its spread, he said, because of the hypersensitivity of broaching the subject of HIV screening. HB 321 eliminates the metaphorical eggshells.
David W. Poole, director of legislative affairs of the AIDS Healthcare Foundation’s Southern Bureau, argues that the stigma presently attached to HIV is a result of the criminal penalties of transmitting the disease.
Despite the fact that contracting HIV is no longer a sure death sentence, as it was 20 years ago when it first broke out, “criminal laws in the state have not been updated to reflect that,” Poole said.
According to ProPublica, at least 35 states have criminal laws that punish HIV-positive people for exposing others to the virus. In Florida, it can be a felony crime to transmit HIV to others without consent of contact.
“All it does is increase stigma,” Poole said. “It will drive people underground and they will be less reticent to get tested.”
Thompson said the bill’s bipartisan origins — it was also sponsored by Republican House Representative Bryan Avila — indicates a consensus that HIV is a problem in Florida.
According to the Centers for Disease Control and Prevention, Florida had the highest number of new HIV diagnoses in the United States in 2013 with 5,377 HIV-positive results statewide.
Trailing behind Florida in new HIV diagnoses are California (5,334) and Texas (4,854).
Florida has the smallest population of the three states. The U.S. Census Bureau estimates that Florida had a population of about 19.6 million people in 2013, while California had 38.4 million and Texas had 26.5 million.
Florida, however, leads the nation in HIV-testing efforts, according to Mara Burger, press secretary for the Florida Department of Health.
Indeed, CDC reports show that Florida conducted the largest number of HIV tests in CDC-funded facilities in 2011, the last year for which it has a comprehensive national report. Florida conducted more than 417,000 HIV tests in 2011, with the runner-up, Texas, conducting 266,929.
Getting tested is one of the most important steps in preventing HIV, Burger said. It informs patients of their status and helps them modify their lifestyle accordingly.
HB 321, however, does not require providers to test for HIV.
“It’s not a bill that says, ‘All providers are going to test for HIV every year.’ That would be a dream,” Ruppal said. “But from a privacy standpoint, patients should always have the option to opt out of anything.”