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Michigan health agency calls on local departments to stop stigmatizing HIV


LANSING — The Michigan Department of Community Health issued a letter to local health departments Friday which “strongly encourages” those public bodies to cease using Client Acknowledgment forms that are legally inaccurate.

The documents are used ostensibly to inform newly diagnosed HIV-positive persons of their legal responsibility under Michigan law to inform sexual partners of their status or face possible felony charges. But those documents came under fire when a Michigan Messenger investigation published in February revealed that the documents not only misstated the HIV disclosure law, but had been used as evidence in criminal proceedings around the state.

“The Michigan Department of Community Health (MDCH) does not endorse or encourage the use of ‘Client Acknowledgment Forms,’” wrote Amna Osman, director of the Division of Health, Wellness and Disease Control. “We do not support or endorse any practice or policy which may contribute to stigmatizing HIV or associated risk behaviors as this may serve as a deterrent to individuals seeking testing to learn their HIV status, or from seeking care, if they know they are HIV-infected.”

Osman also indicated in the letter that such forms are not required under Michigan law.

“We strongly encourage LHDs (local health departments) that are currently using Client Acknowledgment forms to review this practice immediately,” Osman wrote.

This is not the first time such documents have come under fire. In 2007, the Ingham County Health Department came under fire for documents called “HIV contracts.” The Michigan Department of Community Health said then such documents were not required under Michigan’s laws. Michigan law says only that those who test positive for HIV are to be informed of Michigan’s felony disclosure law, which requires disclosure of an HIV-positive test result prior to sexual penetration “however slight.”

The news was greeted warmly by activists who had raised concerns about the documents in February.

“This is strongly worded and hopefully will dissuade local health departments from continuing the practice of using these forms,” said Jay Kaplan, staff attorney for the ACLU of Michigan Lesbian, Gay, Bisexual, and Transgender Project.

“The Michigan Department of Community Health should be applauded for stepping up and doing the right thing. HIV positive Michiganders have civil rights, and just like every other person in this state, is owed protection from policies that would infringe on those rights,” said David Holtz, executive director of Progress Michigan. “This move will protect the rights of an estimated 18,000 HIV positive persons in Michigan, and will go a long way toward chipping away at the unfair stigma assigned to folks fighting this disease.”

“The response from MDCH, we think, is appropriate,” says Rene Bennett-Carlson, managing attorney at the Center for HIV Law and Policy in New York City. “We appreciate their acknowledgment that these policies discriminate and stigmatize against the HIV-positive community in Michigan. We look forward to seeing what alternatives the local health departments engage in to eliminate these practices and how they adopt best practices for the people they are serving.”

Carlson, said the MDCH letter was a bold move that should be copied wherever HIV-positive people are being required to sign documents related to their HIV status and the state’s criminal laws. She specifically identified Missouri, where activists have noted a significant increase in the number of criminal prosecutions under that state’s HIV exposure laws.

“We would recommend in any situation where there are forms that they should be eliminated and the local health departments should not continue stigmatizing and discriminatory practices that single out HIV positive people because of their status,” Carlson said. “Documents that make people acknowledge their HIV-positive status and sign that they can be prosecuted because of their HIV positive status are significant barriers.”

Jacqueline Lapine, communications director from the Missouri Department of Health and Senior Services, did not immediately return inquiries from Michigan Messenger as to whether or not the state would follow Michigan’s example.

“The National Association of People With AIDS (NAPWA) applauds the Michigan Department of Community Health for protecting the rights of people living with HIV. No newly diagnosed individual should have to endure the indignity of having their humanity challenged and called into question in such a disrespectful manner. No other patients with health conditions, infectious or otherwise, are forced to sign away a part of their human rights,” said Vanessa Johnson, executive vice president of NAPWA, a national organization that advocates for people living with HIV. “Fortunately, there appears to be a movement afoot by state health departments to review these types of offensive documents. For this we applaud the Positive Justice Project for its leadership on this issue and the National Association of State and Territorial AIDS Directors (NASTAD) for the issuance of a statement advocating for the repeal of HIV criminalization.”

NASTAD issued a statement in March criticizing laws which criminalize HIV-positive people. MDCH’s Osman serves on NASTAD’s Board of Directors and is in line to become the group’s new board chair later this year, said NASTAD’s Communications Director Terrence Moore.

“Our hope is that more states will move in the direction that Michigan has and treat the disease instead of penalizing the person for having the disease,” Johnson said, echoing Bennett.

“The Michigan Department of Community Health’s (MDCH) mailed directive to county health departments to cease and desist the inclusion of inaccurate requirements on HIV disclosure forms went above and beyond what Equality Michigan asked of the Department,” said Emily Dievendorf, policy director for Equality Michigan, an Lesbian, Gay, Bisexual and Transgender rights advocacy group based in Detroit. “We are thankful for this recently demonstrated commitment by MDCH to balancing the public’s right to both justice and good health.”

“The letter speaks more accurately to the impact of stigma on HIV positive people,” said Mark Peterson, director from the Michigan Positive Action Coalition. “I think the language is also speaking more appropriately to what local health departments are mandated to do and not go beyond with their philosophical issues. I was glad to see that.”

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