Wednesday, December 30, 2009

Why You're Glad You're Not a Teenager Anymore

We got a call this morning that really got us thinking about the difficulties of facing HIV as an adolescent.

Theresa called with concerns about her godson, Gerard. Gerard is 16 and has been HIV-positive since birth. Theresa has known about his status for his entire life, and when Gerard's mother died she took him in for several years. Theresa knew that Gerard has had a steady boyfriend for the past year, and yesterday while she and Gerard were hanging out in her kitchen she asked him if he had told his boyfriend about his HIV status. Gerard said he had not, and added that they always had protected sex. Theresa asked Gerard if he was afraid to tell his boyfriend about his HIV status, and he said he wasn't; he just hadn't gotten around to it.

So Theresa called us, wanting to know how her godson's actions squared with Illinois law. We told her that the law requires a person with HIV to disclose that information before engaging in "intimate contact" with another person, and that the law defines "intimate contact" as anything which might transmit HIV, whether it does or not. So under a strict reading of the law, Gerard had committed a felony every time he and his boyfriend had sex.

Next came the really difficult question. What would we advise her to do?

One thing was clear: under the Illinois AIDS Confidentiality Act, Theresa could not legally inform Gerard's boyfriend (or anyone else, for that matter) of Gerard's HIV status without Gerard's written permission. She said she had no intention of betraying Gerard's trust that way. But what could she advise Gerard to do? Here are the suggestions we made:

He could tell his boyfriend that the two of them should go get tested for all STDs, including HIV. After all, public health departments routinely put out the message that sexually active gay men should get STD tests done every six months (yes, that's a ridiculous message to put out, as it suggests that gay men can do nothing short of celibacy to eliminate their risk of contracting STDs, unlike straight people). Hopefully the boyfriend's tests would all come back negative. Then Gerard could disclose his HIV status to his boyfriend, emphasizing that safe sex works. Perhaps Gerard would want to include his boyfriend's parents in that discussion.

He could self-report to the local department of health, and have them inform his boyfriend that he may have been exposed to HIV. They would do so without disclosing Gerard's name. Of course, if the boyfriend hasn't been with anyone but Gerard in the last year, he would know who the department of health was talking about. And getting the information from health authorities, rather than from Gerard personally, might create a lot of bad feelings.

He could end the relationship and keep quiet. But as Theresa pointed out, this option prevents Gerard's boyfriend from learning important information for his own sexual health. Theresa felt strongly that the boyfriend should get an HIV test.

Lastly, Theresa asked what repercussions Gerard might face. Would he be arrested? Put in jail? We told her that the likelihood of a criminal prosecution in a case like this is very low, at least here in Cook County, Illinois. A bigger concern might be the boyfriend's parents threatening some sort of civil legal action against Gerard for putting their son in jeopardy without informing him first. But it seemed to us that the real risk Gerard faces is that his HIV status becomes widely known at his school; it's hard to imagine that any 16-year-old boy who learns he's been dating someone with HIV for a year will tell none of his friends at school. And if Gerard's status became common knowledge at school, it's hard to know how difficult his life there might become.

We sure hope things work out for Gerard and his boyfriend.

Tuesday, December 22, 2009

More CORBA Help

Perhaps you recall that last spring President Obama signed the American Recovery and Reinvestment Act, which among other things provides a 65% subsidy for COBRA premiums for those who become COBRA eligible between September 1, 2008 and December 31, 2009. If you don't recall this momentous event, then clearly you have not been reading our blog regularly, like all good people should, since we blogged about it back then. We even included a link to the IRS regulations that govern the program. Gosh, we are marvelous, not to mention thorough.

Well, now there's news that the program will be extended to February 28, 2010. The extension is included as part of the Department of Defense Appropriations Act, which the President signed into law on December 19.

Here's an important thing to know about this extension: your COBRA coverage doesn't have to begin by February 28, 2010. Rather, your COBRA eligibility has to begin by February 28, 2010. For example, if you lose your job on February 28, you would be eligible for the extension, even though you probably won't have your COBRA coverage in place until a month or two later.

If you really want to make your brain overheat, read through the Act here. You'll have to wade through 63 pages of blah-blah-blah until you get to the COBRA stuff in Section 1010. Here's our favorite tidbit:

(c) RULES RELATED TO 2009 EXTENSION.—Subsection (a) of such section is further amended by adding at the end the following: ‘‘(16) RULES RELATED TO 2009 EXTENSION.—
(A) ELECTION TO PAY PREMIUMS RETROACTIVELY AND MAINTAIN COBRA COVERAGE.—In the case of any premium for a period of coverage during an assistance eligible
individual’s transition period, such individual shall be treated for purposes of any COBRA continuation provision as having timely paid the amount of such premium if—
(i) such individual was covered under the COBRA continuation coverage to which such premium relates for the period of coverage immediately preceding such transition period, and
(ii) such individual pays, not later than 60 days after the date of the enactment of this paragraph (or,if later, 30 days after the date of provision of the notification required under subparagraph (D)(ii)), the amount of such premium, after the application of paragraph
(1)(A).

That sure clears things up.

Thursday, December 17, 2009

Flee Fornication!

And here we have our nominee for the most useless, moralizing, irresponsible and poorly sung HIV prevention message ("Limit yourself to one faithful spouse / And flee fornication!") to disgrace the Internet.

And what a shame the poor dear can't pronounce 'trichomonas.'

Discuss.

Tuesday, December 1, 2009

ALCC in the News

The venerable Chicago Tribune ran a feature today about the looming repeal of the HIV travel ban -- and quoted our paralegal Kate Miller. Check out the article here.

And if you want to be truly flabbergasted, read through the comments people left after reading the article. Perhaps it's not terribly surprising, in light of all the deliberate misinformation that has been promulgated in an effort to scuttle health care reform, that so many people think immigrants are granted free health care in America. But it's astonishing that in 2009 so many people appear willfully and proudly ignorant of the basics of HIV infection. One pinhead even calls HIV an "easily communicable, incurable, and deadly disease." Oy gevult. Some people shouldn't be allowed access to computers.