New York Times Examines Methods Used To Control TB in New York City, Similar Measures for HIV Control

The New York Times on Tuesday examined how New York City might benefit from using the same techniques used to reduce the incidence of tuberculosis in the early 1990s to control the spread of HIV. According to the Times, when TB cases re-emerged in New York City -- increasing to 3,811 new cases in 1992 from 1,514 new cases in 1980 -- city officials adopted a "tough love approach" that included the DOTS strategy and forcible hospital admission for people who would not adhere to treatment regimens. By 2001, the number of recorded new TB cases had decreased to 1,261. Although there are concerns that forced hospital admissions might be abused since TB primarily affects ethnic minorities and the poor, all TB patients who are admitted to hospitals in the city are assigned a lawyer, and patients' good behavior often is rewarded. The New York City Department of Health and Mental Hygiene has proposed implementing similar measures to control HIV. According to Health Commissioner Thomas Frieden, there are about 20,000 HIV-positive people in New York City who are unaware of their status. Under the proposed changes, obtaining consent for HIV testing would be made easier for health care workers, and HIV cases would be monitored in a manner similar to TB cases to ensure that patients adhere to their drug regimens. Opponents of the proposal are concerned that some people might be forced to get tested for HIV or might have their privacy violated (Lerner, New York Times, 6/27).