Summer 2006

On 25th Aniversary, AIDS Coordinating Committee Hosts Conference

On June 5, 1981, the Centers for Disease Control and Prevention (CDC) announced the first diagnoses of a new and deadly infectious disease that ravaged the immune systems of homosexual men. Twenty five years later, HIV/AIDS has killed twenty five million people – gay, straight, men, women, and children – and is the leading cause of death in many developing countries. An estimated 38.6 million people are living with HIV/AIDS worldwide, and 4.1 million became infected in 2005.

These statistics are frightening and discouraging, yet they do not, in themselves, paint a true picture of the distress experienced by people living with HIV/AIDS (PLWHA). Life-saving antiretroviral (ARV) treatment is not available to the majority of PLWHA in developing countries, and even in the United States low-income patients find themselves on state-funded AIDS Drugs Assistance Program (ADAP) waiting lists. Many PLWHA also face significant levels of stigma and discrimination in their communities. In the United States and abroad, PLWHA are denied access to healthcare, education, employment, and housing; restriction of these basic human rights creates emotional suffering and compromises medical treatment. Fear of discrimination prevents PLWHA and individuals at risk for HIV/AIDS from accessing healthcare and HIV prevention education, thereby contributing to the spread of the epidemic.

By fighting discrimination and ensuring PLWHA access to basic services, lawyers can play a crucial role in fighting the AIDS epidemic. The CDC recognized this link between law and public health in the 2001 Revised Guidelines on HIV Testing and Counseling:

Clients who test positive should be referred to legal services as soon as possible after learning their test result for counseling on how to prevent discrimination in employment, housing, and public accommodation by only disclosing their status to those who have a legal need to know.

The guideline’s proponents (lawyers experienced in AIDS discrimination cases) argued that because such cases typically result from a client’s unnecessary disclosure of his/her HIV status to a “trusted” friend, neighbor, or colleague, prompt legal counseling about the client’s disclosure obligations would help avoid discrimination, thereby preserving the client’s employment, health care, housing, etc., and, by extension, encouraging others at risk of infection to get tested and receive prevention counseling.

Recognizing the urgent need to address this problem in order to stem HIV’s resurgent spread in the U.S. and to mitigate its ever-widening impact abroad, the ABA is developing an “AIDS Legal Services Initiative” to help educate PLWHA about their human rights to health care and protection from discrimination; increase access to legal services to secure those rights; and, where appropriate, help develop and advocate policy improvements to advance these efforts. This Initiative seeks to complement existing legal services, provided by dedicated and experienced attorneys around the country.

On May 16—21, 2006, over 100 lawyers working with PLWHA and on HIV/AIDS related issues gathered in Portland, Ore. for the HIV/AIDS Law & Practice Conference: from Nuts & Bolts to Cutting Edge. The Conference, sponsored by the ABA AIDS Coordinating Committee and the Young Lawyers Division (in conjunction with the YLD Annual Meeting), addressed issues such as: discrimination in employment, housing, and healthcare, immigration law, criminalization of HIV transmission, government benefits, and the impact of HIV/AIDS on women and girls. Presenters included experienced and dedicated lawyers in private practice, legal service organizations, and government agencies.

The opening sessions focused on the interconnections between law and public health in combating HIV/AIDS, and was delivered to a combined audience of HIV/AIDS lawyers and members of the Young Lawyers Division, whose service project for this class year, Answering the Call, seeks to educate young legal professionals about the HIV epidemic and engage them in the provision of legal services to PLWHA. Dr. Edward Thomson, Acting Director of the Coordinating Center for Health Promotion at the CDC, discussed various legal powers traditionally exercised by public health and their relationship to HIV/AIDS.

Dr. Bernard Branson, Associate Director for Laboratory Diagnostics Division of HIV/AIDS Prevention at the CDC, followed the keynote address by presenting the CDC recommendations implementing routine, universal testing for HIV (i.e., testing for all individuals who, in the course of receiving healthcare, undergo blood tests). Routine testing engenders some controversy among public health and law practitioners because of the possible implications on patients’ informed consent and confidentiality. Audience members raised concerns that routine testing – which would replace the current systems of opt-in or opt-out testing – would also compromise the delivery of pre-test counseling and might deter some at-risk individuals from accessing healthcare in the first place.

Conference participants attended a mock Social Security Insurance (SSI) hearing where an actual HIV-positive client and his attorney petitioned an administrative law judge for SSI benefits. The hearing highlighted the importance of SSI benefits to PLWHA who are dealing with chronic fatigue, recurring physical symptoms and emotional distress, and who rely on SSI payments to meet their living expenses.

The closing plenary session discussed the future of HIV legal services. The panel addressed the need for increased funding and the implications of the proposed Ryan White CARE Act restrictions on funding for non-medical services for PLWHA; the need for collaboration and interaction between healthcare providers and lawyers; and the need for continuing policy advocacy efforts to ensure that the rights of PLWHA are protected.

The conference program and materials are available on the AIDS Coordination Project’s website at http://www.abanet.org/AIDS/conferences/home.html.

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