On October 1st, Island Health announced that HIV testing will be offered to all patients at the Port Alberni Hospital and will be expanded to other facilities on the island throughout the next year.
Island Health Press Release: Knowing is Better: Routine HIV testing to be offered to all patients admitted to hospital in Port Alberni
There is little doubt that increased testing benefits both individuals being tested and the community at large. Knowing ones status is not only beneficial to the person tested, but is also a tool for curbing infection rates in the general population; in the case of HIV, the more people who know their status, the more people who can start accessing treatment options. Treatment has been shown to reduce infection rates as the risk for transmitting HIV decreases drastically. More importantly, it results in better health outcomes for the individual living with HIV. It is clear that increased routine testing can be an effective tool for reducing the rates of HIV infections on Vancouver Island, and the rest of the province.
What isn’t clear, however, is the process of informed consent that is critical to any request for medical testing. In Island Health’s news release, it states that “[a]s with all medical information and investigations, testing happens once patient consent is given”. One concern surrounding this process is that Canada leads the world in HIV non-disclosure cases due to the fuzzy, incoherent and confusing guidelines surrounding the criminality of HIV non-disclosure. In a social and political atmosphere of violent stigma and criminalization, consent with all the necessary information is critical to allowing persons getting tested to have the necessary knowledge to make informed decisions that, for them, can carry life-long consequences, including the potential for facing serious criminal charges such as aggravated sexual assault, even in cases that do not result in HIV transmissions.
Consent is a process that goes beyond just asking a question, and receiving an answer. Consent must be practiced with all the information necessary to make the decision meaningful, freely-given and informed. Consent can not be practiced within a context of misinformation, intoxication (including any medication that can alter ones capacity to freely consent), coercion, or intimidation. In this context, it becomes critical to inform individuals prior to testing that a positive result may lead to serious legal and social ramifications. Until the Supreme Court, and the Canadian government see HIV as a health issue and not a criminal one, it is important that those offering routine testing be educated on the dangerous consequences of receiving a positive test result.
It is our hope that Island Health implements strong structures and guidelines for those offering routine testing. This will ensure that patients receive the necessary information in regards to the complexities surrounding HIV in a country that increasingly criminalizes it. It is also our hope that Island Health develops progressive patient-centered policies that challenge HIV criminalization and work towards dismantling HIV stigma and discrimination. Finally, it is of utmost importance that pre and post testing support services be offered to anyone interested in receiving a test as to ensure their full understanding of the process.
With care,
Sarah Wilson and Piotr Burek
Sarah Wilson is the Support and Advocacy worker for the Vancouver Island persons living with HIV/AIDS Society (VPWAS).
Piotr Burek is the Co-Chair of VPWAS and also works at a Sexual Assault centre providing education about sexualized violence, practicing consent and preventative measures to challenge the culture of non-consent that has established itself in Canada)
HIV Testing Handbook: A Guide to Your Rights (B.C. Civil Liberties Association): https://bccla.org/our_work/hiv-testing-handbook-a-guide-to-your-rights/
Island Health Press Release: Knowing is Better: Routine HIV testing to be offered to all patients admitted to hospital in Port Alberni http://www.viha.ca/about_viha/news/news_releases/nr_knowingisbetter_stophiv_1oct2015.htm
