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Dallas Morning News
Davis and Ellis: Still fighting for comprehensive HIV screening

July 20, 2010
It has been 30 years since the fight against HIV began and 20 years since the Ryan White Care Act was passed. About 575,000 Americans have lost their lives to AIDS.

But because HIV is treatable, many think it is no longer a public health emergency. Yet while the annual number of new infections has not risen in years, the number of individuals living with HIV continues to grow, creating an increasing pool of people capable of transmitting the disease.

In Texas, the number living with HIV/AIDS has increased 42 percent since 2002. In Dallas County, 13,500 were estimated to be living with HIV/AIDS in 2008, an increase of 33 percent over six years.

Unless we intensify prevention efforts, the number of infections - and costs for care - will continue to rise. The lifetime cost of treating HIV is about $355,000 per person, or $25,000 a year, a substantial cost for the county and state.

President Barack Obama recognized the need for a renewed commitment to fight this epidemic and announced a national HIV/AIDS strategy last month. Its goal is to:

* Reduce the number of people who become infected through concentrated community efforts and education.

* Increase access to care and improve health outcomes for people living with HIV.

* Reduce HIV-related health disparities.

One of the crucial steps in this strategy is to link individuals to quality care. The years between HIV infection and AIDS are critical for treatment and prevention of transmission. Unfortunately, many only find out about their illness after AIDS symptoms set in. Almost one in four of all recent diagnoses in Texas received an AIDS diagnosis within one month of their HIV status. Late discovery is common because of shortage of help, costs, shame and risk of legal action.

To mitigate these barriers and increase access to testing, we introduced legislation last session to implement the 2006 CDC recommendations that incorporated HIV testing into routine medical care. Most physicians will only test a patient if they know enough about his or her life to assess risk. While health fairs provide a resource for HIV testing, they often lack privacy. This bill would have allowed individuals to obtain an HIV test at their own doctor's office, regardless of risk status.

According to the CDC, more than 20 percent of people in America with HIV are unaware they're infected. Every nine and a half minutes someone in the United States is infected. There are pockets in our legislative districts where infection rates rival that of African nations.

Dallas County has the highest rate of HIV infection in Texas, with 36 new cases per 100,000 residents. Harris County's statistics are not far behind with 32.5 cases per 100,000.

We have made progress in HIV testing for special populations - now it's time to reform our comprehensive HIV policy to extend screening to all Texans. Studies have shown that the sooner a person is made aware of infection, the sooner he or she will adjust behavior to reduce the risk of transmitting the disease to others. The CDC believes that the number of new cases of HIV each year could decrease by up to 30 percent with routine screening in all heath care settings.

The two of us plan to submit this important public health initiative again next session in Austin. Meanwhile, we urge all individuals to take control of their health by getting an HIV test; policy reform can only get us part of the way in the fight against this epidemic.

**State Rep. Yvonne Davis represents District 11 in southern Dallas County; her e-mail address is . State Sen. Rodney Ellis represents District 13 in the Houston area; his e-mail address is