Manitoba mistake: Forced HIV testing is never justified

via Shawn Syms
extra.ca

Manitoba legislators are poised to force people to get tested for HIV and hand over the results. The Testing of Bodily Fluids and Disclosure Act — introduced earlier this month by the province's health minister Theresa Oswald — is supposed to protect first responders such as paramedics, or anyone else who offers first aid to an injured person.

According to a Winnipeg Free Press report, the legislation would allow someone to apply for a judicial blood-testing order if they believe they've been exposed to a blood-borne disease, such as HIV or hepatitis.

A health minister should know better. Oswald claims this bill would provide "peace of mind" to emergency workers — but the law would offer little protection at too great a human-rights cost.

The best way to show respect for the efforts of first responders and health care professionals — and demonstrate genuine dedication to their health and safety — is to provide education about the actual risks, and implement safeguards to reduce those risks.

Workplace exposure to HIV is not impossible — but the real risk is dramatically low. So much so, there has only been one confirmed case in Canada over the past twenty-five years. According to the Canadian HIV/AIDS Legal Network, practical things that would actually offer protection against occupational exposure include needles with safety features that reduce the possibility of needlestick injuries, Kevlar-lined gloves for police officers and proper containers for the disposal of sharp implements.

And if there is a genuine risk of HIV exposure, a person can take a one-month course of treatment called post-exposure prophylaxis (PEP), which is believed to greatly reduce any likelihood of infection.

If someone's broken skin, mucus membranes or internal tissues have clearly been exposed to someone else's blood, they should get PEP. If not, they likely shouldn't. Some paramedics have argued they need the other person's test results to determine if PEP is needed. That's a mistake.

A potentially exposed person needs to go on PEP almost immediately, within mere hours after the risky incident. Forcing a test and awaiting the results means too much delay. And a negative test result could offer false reassurance, because of the window period before HIV is detectable.

Forced testing offers no benefit in the case of diseases like hepatitis either. All health workers should be vaccinated against Hep B and there is no preventative treatment for Hep C, so there is no benefit to knowing if the potential source person has it. On the other hand, when someone's HIV status is exposed to others unnecessarily, the risks can be unpredictable and life-changing.

We may imagine times have changed, but according to a survey by the Public Health Association of Canada, "20 percent of Canadians do not believe in supporting the rights of people with HIV/AIDS" — and many people would wrongly avoid even casual contact with someone HIV-positive. So people living with the virus have every right to be wary of human-rights abuses and undeserved mistreatment.

Let's show the life-saving efforts of professionals dedicated to our health and safety — and well as the rights, security and well-being of people with HIV — the concern, appreciation and respect that they all deserve.

For more information, see the Canadian HIV/AIDS Legal Network's excellent primer on forced HIV testing.