Proposal is Important Step to Removing Barriers to HIV Treatment, Preventing Infection and Saving Lives
Legislation Would Build on Progress Towards Ending the AIDS Epidemic in New York by the end of 2020
Governor Andrew M. Cuomo today announced a proposal, to be introduced this legislative session, which allows teens with HIV to receive treatment without requiring parental consent. Under state law, minors generally cannot consent to medical care. An exception was made decades ago for the treatment of sexually transmitted diseases, but HIV was not listed due lack of adequate treatments and frequently fatal outcomes. Medical treatments have simplified and improved significantly over time. Further, failure to treat can lead to serious health consequences. The Governor’s proposal adds HIV to the list of exceptions in order to increase treatment for minors that may be affected with HIV – preventing infection and ultimately saving lives.
“We should not allow stigma or personal circumstances to prevent someone with HIV from receiving support,” said Governor Cuomo. “This proposal helps ensure that teens living with HIV have access to the treatment they need, and it marks another critical step forward in our effort to end the epidemic. I am proud to stand up this vulnerable population, and I urge the legislature to join me by passing this proposal this year.”
In the early days, HIV was considered a death sentence and was a difficult disease to treat. Treatment was inaccessible, expensive and harsh. Further, there were significant collateral health consequences associated with HIV treatment. Today, HIV is not a death sentence and treatment is now simplified and in fact can be conducted in primary care physician setting. But, importantly, the failure to treat can lead to serious health consequences that often cannot be reversed – including disease progression, as well as increased transmission of the virus to others. In 2013, there were 141 newly diagnosed HIV cases in New York State among 13 to 19 year olds, and 951 people in this age group living with the virus.
These proposed changes make it easier for HIV-positive youth – who have lower rates of suppression in the state – to access important treatments that help to suppress the virus, enabling them to live longer and healthier lives. In 2013, only 48% of HIV-positive persons aged 13 to 24 were virally suppressed, compared to the overall statewide rate of 63%.
The proposed legislation also includes the ability for HIV preventive services to be provided to minors. This is important as highly effective new approaches become available, such as Pre-Exposure Prophylaxis, or PrEP, which is a once-daily pill that protects individuals from HIV infection. For youth who engage in high-risk sexual behaviors and experience repeated STD infections, PrEP may become an important prevention tool that is not currently available to them without parental consent.
The Governor’s proposal complements recently-enacted state regulations that ban discrimination and harassment against transgender people, and acknowledges the stigma that many face when diagnosed with HIV. Teens in particular who become infected with HIV may be reluctant to talk to their parents about their sexual health. Allowing treatment and HIV prevention without parental consent will also help teens who are estranged from their parents.
Dr. David Rosenthal, Director for the Center for Young Adult, Adolescent and Pediatric HIV at Northwell Health in Great Neck said: “It puts me in a difficult situation when I find a 14-year-old who has HIV. I can test the patient, I can tell them that they have HIV and that I have medications I can give them to treat them effectively, but I can’t do that unless I tell their parents. We need to realize that treatment of HIV should have the same level of protection for minors, as does other sexually transmitted diseases.”
Dr. Donna Futterman, Professor of Clinical Pediatrics Director, Adolescent AIDS Program at Children’s Hospital at Montefiore Medical Center in the Bronx said: “As a pediatrician and the Director of the Adolescent AIDS Program at Montefiore Medical Center, a program that has provided care to over 650 HIV+ youth since 1989, I applaud the forward-thinking leadership Governor Cuomo and the DOH are providing by calling for an end to laws that prevent minor youth from consenting to HIV treatment and prevention medications. Already youth are able to consent to treatments for other sexual health conditions such as STDs and birth control and access to HIV treatment should be no different.”
Under the Governor’s leadership, New York State has made great strides toward the Governor’s goal to end AIDS by the end of 2020. No new cases of mother-to-child transmission of HIV have been reported since August of 2014, the first time there have been no new cases over a twelve-month period since the outbreak of the AIDS epidemic. Additionally, New York State has been recognized as a national leader in the effort to increase availability of PrEP. Since June 2014, there has been over a 400 percent increase in PrEP use among Medicaid enrollees.
This fall, the Governor committed $200 million in new funding over several years toward HIV/AIDS efforts, which is in addition to the $2.5 billion in public funding that the state currently directs toward addressing the disease.
In addition to the billions of dollars the State directs to HIV/AIDS efforts, New York State will make additional financial and programmatic commitments to ensure that New York State Ends AIDS by the end of 2020, including:
- Ensure all New Yorkers have access to HIV testing services;
- Continue to expand access to PrEP for those with the highest rates of HIV infection; and
- Work across systems of care to identify HIV-infected persons who are not virally suppressed and provide them with additional assistance.