Isle red tape delays quick test for HIV

Concern over lab rules keeps Hawaii from offering an exam that utilizes saliva

HIV/AIDS prevention advocates are asking why it is taking so long for Hawaii to do what nearly all other states have done: provide for a rapid, on-the-spot HIV test.

"They're taking an awful long time for something so simple," said Scott Orton, HIV/AIDS awareness advocate.

The current test involves collecting a blood specimen for laboratory analysis. The state Health Department wants to replace it with a 20-minute OraQuick test using a swab to collect oral fluids. No blood is involved.

Preliminary on-the-spot results and counseling will be provided.

"We really want this to be happening," said Peter Whiticar, chief of the Health Department's STD/AIDS Prevention Branch. "From a program perspective, we want this as soon as possible for HIV prevention. It's a very important tool."

He said the delay is not related to efficacy of the rapid test, but the need to overhaul laboratory rules, which "is taking significantly longer. ... There are a lot of considerations with private labs and physicians.

"Laboratory reporting and administrative rules affect a lot of people," Whiticar said. "It is really important that they go through a proper and thorough review process."

"We're hopeful by the end of the summer it will be resolved," said Paul Groesbeck, Life Foundation executive director. He said the foundation, which does outreach HIV testing, began training its staff last year for the rapid HIV test.

Orton expressed concern that the delay "promotes the spread of HIV in this state by those unaware of their status. Those infected, but unaware of their HIV status, could be spreading the HIV virus worldwide to tourists and others," he said.

Dianne Okumura, chief of the Health Department's Office of Health Care Assurance, sent Orton a letter explaining that amendments to laboratory rules in 2002 caused some concerns.

The staff recognized "some of the requirements for laboratories would create difficulties and be too stringent," she said. Thus, a work group was created to amend the regulations, she said.

"DOH is not trying to create barriers but is cognizant of the need to create a system that will facilitate the use of tests such as the rapid HIV test in a cost-efficient and less stringent manner," she wrote.

She said every effort is being made to facilitate the amendment process, which began last September. A final draft is being prepared for legal review, she said. The proposed rules will be posted and hearings scheduled for public comment before they go to the governor.

Whiticar said the rapid HIV test is strongly promoted by the U.S. Centers for Disease Control and Prevention "as a way of getting to people that may not be tested through other means."

Results are not available for one or two weeks after blood is drawn in current tests and sent to a laboratory, he said. "Unfortunately, we lose people in that time. They don't come back."

The OraQuick test is easy, and it appeals to people who do not want to wait for the results, Whiticar said.

Those testing positive in the rapid test will be offered a blood test on the spot to get a confirmed result, he said. "We don't want people leaving with just a preliminary result."

Bolder efforts called for as AIDS crisis turns 25

The Life Foundation was to observe today the 25th anniversary of the first warning in the United States of what turned out to be AIDS -- and "the world should learn a lesson from AIDS," Executive Director Paul Groesbeck said.

"AIDS is not over by any means," he said, "but there will be something else, whether in 50 or 100 years. People should be able to look back on the way the world responded to AIDS and see what was done wrong and what was done right."

The warning issued by the U.S. Centers for Disease Control and Prevention on June 5, 1981, concerned what was thought to be a rare form of pneumonia among a small group of young gay men in Los Angeles.

Worldwide, the foundation said, HIV/AIDS is the leading cause of death among people age 15 to 59, and half of all new infections occur in those under age 25.

"Despite 25 years and billions of dollars, a cure for HIV/AIDS has not been found," said the Life Foundation, formed in 1983 to provide services and education about the infection in Hawaii.

"Certainly, there has been a lot of courage and selflessness in confronting it," Groesbeck said.

But he added, "I'm angry for the people who are lost. Had there been different responses, had the political and religious leaders of the world been more proactive and less scared about sex or homosexuality or racism, then maybe this epidemic would not have gotten so out of control."

There was no one in power providing the kind of leadership President Franklin Roosevelt did when he said, "We're going to cure polio," Groesbeck said.

"There was a lot of money to fight the (HIV/AIDS) epidemic, but there wasn't a clarion call from the leader."

There has been a lot of progress, and drugs have been developed that can prolong life, but people should not become complacent, he said.

Today marks "a 25-year observance of the beginning of something terrible," he said. "I think we've seen the end of the beginning. We have to treat it that way and stay vigilant and find it and beat it to death.

"I think AIDS can be banished from these beautiful islands, but everyone has to be cognizant that it is here."

The Life Foundation runs the state's most comprehensive HIV prevention program and provides services to more than 600 HIV-positive men, women and children.