HIV Prevention Act of 1997

The HIV Prevention Act of 1997 bill was introduced to the United States House of Representatives on March 13, 1997 as H.R. 1026 by Thomas Coburn (R-Oklahoma). A companion bill was introduced to the U.S. Senate as S. 503 by Don Nickles (R-Oklahoma).

The bill would have brought policy towards HIV/AIDS, often referred to as 'AIDS exceptionalism', in line with the public health approach used for other infectious diseases. It would have established confidential HIV reporting and partner notification nationwide, required accused sex offenders to be tested for HIV, and allow health-care providers to test for HIV before exposing their employees in the course of an invasive medical procedure. The bill was endorsed by the American Medical Association.

Findings

Regarding the Act, the United States Congress found:

• The States should recognize that the terms 'acquired immune deficiency syndrome' and 'AIDS' are obsolete. In the case of individuals who are infected with the Human Immunodeficiency Virus (commonly known as HIV), the more important medical fact for the individuals and for the protection of the public health is the fact of infection, and not just the later development of AIDS (the stage at which the infection causes symptoms). The term `HIV disease', meaning infection with HIV regardless of whether the infection has progressed to AIDS, more correctly defines the medical condition.
• The medical, public health, political, and community leadership must focus on the full course of HIV disease rather than concentrating on later stages of the disease. Continual focus on AIDS rather than the entire spectrum of HIV disease has left our Nation unable to deal adequately with the epidemic. Federal and State data collection efforts should focus on obtaining data as early as possible after infection occurs, while continuing to collect data on the symptomatic stage of the disease.
• Recent medical breakthroughs may enable doctors to treat HIV disease as a chronic disease rather than as a terminal disease. Early intervention in the progression of the infection is imperative to prolonging and improving the lives of individuals with the disease.
• The Centers for Disease Control and Prevention has recommended partner notification as a primary prevention service. The health needs of the general public, and the care and protection of those who do not have the disease, should be balanced with the needs of individuals with the disease in a manner that allows for the infected individuals to receive optimal medical care and for public health services to protect the uninfected.
• Individuals with HIV disease have an obligation to protect others from being exposed to HIV by avoiding behaviors that place others at risk of becoming infected. The States should have in effect laws providing that intentionally infecting others with HIV is a felony.

Amendments

The act proposed the following amendments to the Social Security Act:

• All positive HIV test results would be reported to a state public health officer for statistical purposes but also to enable a program of partner notification.
• A partner notification program that would inform individuals who may have been at risk of being infected by an individual with positive test results, whether through sexual contact or sharing of drug paraphernalia such as hypodermic needles.
• Defendants in rape cases would be tested within 48 hours of an indictment, with the results of the test being made available to everyone involved and available for use in court.
• Health professionals and people working for a funeral home would be able to require an HIV test before performing their services.
• Health insurance issuers would be entitled to see the results of an HIV test at their request.
• Adoptive parents would be entitled to see the HIV test results of a child before completing the final stages of the adoption process.
• Health professionals with an HIV infection would be required to inform patients of their HIV status where there was a risk of infection.

The Act expresses the sense of the Congress that:

• The States should have in effect laws providing that, in the case of an individual who knows that he or she has HIV disease, it is a felony for the individual to infect another with HIV if the individual engages in the behaviors involved with the intent of so infecting the other individual.
• Strict confidentiality should be maintained in carrying out the provisions of section 1930A of the Social Security Act.

Companion Bill: S. 503

A companion Bill was introduced on March 20, 1997 as S. 503 by Don Nickles (R-Oklahoma). This Act mandated that States require:

• Confidential reporting of human immunodeficiency virus (HIV) positive results by the entity performing the test to the State public health officer .
• Notification by the State public health officer of individuals who may have been exposed to HIV and State cooperation regarding national notification .
• Mandatory testing of individuals indicted for a crime involving force or the threat of force to compel sexual activity, with related notification of victims and their attorneys, allowing use of positive test results, as relevant, in related judicial proceedings.
• Allowing a health professional to not perform a procedure that would place the professional at risk of becoming infected unless the patient undergoes the test and the health professional and the patient are notified of the results.
• Allowing a funeral services practitioner to not perform funeral procedures unless the body undergoes a test and the practitioner is notified of the results.
• Mandatory notification of a funeral service practitioner by a health care entity that knows the body is infected with HIV.
• Allowing a health insurance applicant, if required by the insurance issuer to undergo a test, to be notified of the results.
• Allowing a prospective adoptive parent to choose to be informed of the adoptive child's HIV status (if known by the adoption agency).

In addition, the Act expresses the sense of the Congress that:

• With respect to health professionals with HIV disease, the professionals should notify their patients in circumstances that place the patients at risk of HIV infection by the professional.
• States should encourage the medical profession to develop related guidelines.
• The States should make it a felony for individuals who know they have HIV disease to intentionally infect another
• Strict confidentiality should be maintained in carrying out certain requirements of this Act.

The last action regarding this Act was made on March 20, 1997 as it was read twice and referred to the Committee on Labor and Human Resources.

Concerns

Many concerns emerged that involved the HIV Prevention Act of 1997. Those included medical privacy and economical issues.

Economic concerns

If passed, the Act would abstain all federal Medicaid funds to any state that does not abide by these amendments. In order to receive Medicaid funds, States would have to implement the Bill's provisions, possibly jeopardizing the source of health care for a considerable amount of AIDS patients. In addition,despite the fact that the Association of State and Territorial Health Officers (ASTHO) estimated that implementation of this legislation would require at least 265 statutory or regulatory changes nationwide, and cost approximately $420 million a year, it provided no new money to finance any of these amendments. For individuals, it would not have supplied for following testing and notification with health care and provides no money, for example, to make Protease Inhibitors available to those who test positive.

Medical privacy concerns

The Act proposed that states report all identities that test positive for HIV to the National Government, along with their sexual/needle sharing partners. Then, the Centers for Disease Control and Prevention (CDC) would establish a national partner notification system, sharing these identities with other states in order to track down and inform individuals who may possibly be infected with the disease by a current or past partner. All states would be required to adopt this national partner notification system despite the fact that some states already have an existing surveillance/identifier system that estimate the number of people infected with HIV from anonymous demographic information. The concern involves privacy issues, along with the fact that no other existing disease is required to be reported and examined by the CDC. Another concern is that if passed, the Act would eliminate anonymous testing options, such as the HIV sample collection kits. Those who appose mandatory names reporting prefer using unique identifiers and sentinel studies, for they believe that national partner notification may even discourage people from being tested in the first place.

Some claim that the national partner notification policy would be unnecessary, for it is already required to have partner notification programs in order to receive funds from the CDC for HIV prevention and Control. The Ryan White Care Act Amendments of 1996 also requires states to notify a spouse of a known HIV-infected patient that he or she may have been exposed to HIV and should seek testing. In addition, some criticize the belief that the Bill includes a sense of the Congress urging states to criminalize the intentional transmission of HIV.

Related legislation

S. 2240: Ryan White Comprehensive AIDS Resources Emergency Act of 1990

The Ryan White Care Act of 1990 was introduced on March 6, 1990 by Edward Kennedy (D-Massachusetts) to provide emergency assistance to localities that are disproportionately affected by HIV and to make direct financial assistance available to States to provide for the development, organization, coordination and operation of more effective and cost efficient systems for the delivery of essential services to individuals and families with HIV disease in urban and rural areas. The last action regarding this Act was made on August 18, 1990 and became Public Law number: 101-381.

H.R. 1538: Comprehensive HIV Prevention Act of 1993

The Comprehensive HIV Prevention Act of 1993 was introduced on March 30, 1993 by Nancy Pelosi (D-California) as H.R. 1538 to amend the Public Health Service Act to promote activities for the prevention of additional cases of infection with HIV. The last action regarding this Act was made on April 26, 1993 by the House Committee on Energy and Commerce, as it was referred to the Subcommittee on Health and the Environment.

H.R. 3937: HIV Prevention Act of 1996

The HIV Prevention Act of 1996 was introduced on August 1, 1996 by Thomas Coburn (R-Oklahoma) as H.R. 3937 to amend title XIX of the Social Security Act with respect to preventing HIV. The last action regarding this Act was made on August 12, 1996 by the House Committee on Commerce, as it was referred to the Subcommittee on Health and Environment.

H.R. 1219: William A. Bailey Comprehensive HIV Prevention Act of 1997

The William A. Bailey Comprehensive HIV Prevention Act of 1997 was introduced as H.R. 1219 on March 21, 1997 by Nancy Pelosi(D-California) to amend the Public Health Service Act to promote activities for the prevention of additional cases of infection HIV. The last action regarding this Act was made on April 4, 1997 by the House Committee on Commerce, as it was referred to the Subcommittee on Health and Environment.

S. 1553: HIV Prevention Act of 2007

The HIV Prevention Act of 2007 was introduced on June 6, 2007 as S. 1553 by Senator Dianne Feinstein (D-California) and Senator Olympia Snowe (R-Maine). This Act aimed to remove the funding restriction in current law requiring that at least 33 percent of all global HIV prevention funding be provided to abstinence-until-marriage programs. The last action regarding this Act was made on June 6, 2007, as it was read twice and referred to the Committee on Foreign Relations.

Congressional actions

The HIV Prevention Act of 1997 was referred to the House Committee on Commerce on March 13, 1997. Subsequently, the Act was referred to the Subcommittee on Health and Environment on March 21, 1997. The last action made was Sponsor introductory remarks on measure on August 7, 1998. There have been no further actions reported since.

External links

• Text of the bill - on the Library of Congress website
• S.503 Information on the companion Bill by Don Nickles - on the Library of Congress website
• Text of HIV Prevention Act of 2007 - on the Library of Congress website
• Information on the Comprehensive HIV Prevention Act of 1993 at govtrack.us
• Information on the HIV Prevention Act of 1996 at govtrack.us
• Information on the William A. Bailey Comprehensive HIV Prevention Act of 1997 at govtrack.us
• Information on the HIV Prevention Act of 2007 at rhrealitycheck.org