According to the Wall Street Journal, next Friday all the Seniors at San Fransisco's Urban High School will have the opportunity to undergo voluntary HIV testing.
Getting tested is voluntary for the students. But Mr. Hamilton believes building up peer expectations will ensure a high level of participation—and serve a public-health goal. Normally, he says, kids worry that getting tested might be interpreted to suggest they are promiscuous. "But if 70 kids get tested and 10 don't, people might wonder why those 10 are the ones who are scared," he says. "Critical mass is really important."
WSJ Article
Under California law no parental permission is required for minors over twelve to receive HIV tests. Let me make an obnoxious statement with a point, it is unethical to administer HIV tests to minors under these circumstances.
Presumably, none of the students at Urban High are currently employed in long term positions with health care benefits. If diagnosed with HIV students will have a preexisting medical condition that, after a long enough break in coverage, will not be covered. The Health Insurance Privacy and Portability Act (HIPPA) does not cover voluntary waivers by the patient. Submitting such waivers to a health insurer is often a precondition to obtaining coverage. Even if the testing clinic refuses to comply, a mention of the test results to any health care provider will make them available to insurance companies. Once a preexisting condition is diagnosed, it is diagnosed for life.
While HIV will eventually require treatment, it is unlikely that any of these high school students require it immediately. HIV testing benefits not the student but the students potential future sex partners. At this point future partners are a hypothetical, the fact that these students will transition their health care coverage at least once in the coming years is a certainty. If covered on a parents policy this transition might not be subject to the control of the minor, if a parent looses their job and coverage so does the student. While it is true that the health care reform act will outlaw denial of coverage based on preexisting conditions, the entire act has been thrown out by a federal court and is currently on appeal.
What we are asking is for minors to make a decision that may disqualify them from private health care coverage for a serious medical condition in order the reduce the risk of HIV transmission to their future sex partners. This is a moral decision that each will need to make. It is not one that should be subject to peer pressure or the value judgments of high school administrators.
And the entire proceeding statement is obnoxious to any rational view of morality or public health. Of course students should be able to be tested for a dangerous and communicable condition without fear of suffering a life long insurance exclusions. Such is not the system we live in, though it is the system in place in every other industrialized nation in the world (and a number of developing countries). These are the human stakes of the health care "debate". We would do well to remind the public of this is the months to come.