Talk Bronx New York

Push in Bronx for H.I.V. Test for All

Dr. Donna Futterman, left, with Rosita Gonzalez and colleagues at Montefiore Medical Center, helped the city shape the plan.

The New York City health department plans to announce on Thursday an ambitious three-year effort to give an H.I.V. test to every adult living in the Bronx, which has a far higher death rate from AIDS than any other borough. The campaign will begin with a push to make the voluntary testing routine in emergency rooms and storefront clinics, where city officials say that cumbersome consent procedures required by state law have deterred doctors from offering the tests.

“Routine would mean if you came into the emergency room for asthma or a broken leg, we test everyone for H.I.V., if they’re willing,” the health commissioner, Dr. Thomas R. Frieden, said in an interview on Wednesday.

While Manhattan has long been the epicenter of the AIDS epidemic in New York, with the highest incidence of both AIDS and H.I.V., the virus that causes it, the Bronx, with its poorer population, has far more deaths from the disease. Public health officials attribute this to people not getting tested until it is too late to treat the virus effectively, thus turning a disease that can now be managed with medication into a death sentence.

Several AIDS experts said on Wednesday that the Bronx campaign was the most aggressive testing effort they could recall in the nation. Two years ago, Washington, D.C., made a high-profile push to test 450,000 residents, enlisting celebrity endorsements and distributing 80,000 free testing kits, but the campaign resulted in only about 45,000 people being tested.

“What’s new here is that we are implementing it on this large a level,” said Dr. Donna Futterman, director of the adolescent AIDS program at Montefiore Medical Center in the Bronx, who helped New York develop the new program. “The Bronx has 1.3 million people. It’s bigger than most cities, bigger than Boston, bigger than Washington. We’re talking about a significant urban population.”

City officials estimate that 40 percent of the 830,000 people ages 18 to 64 in the Bronx have been tested for H.I.V. in the past year. Half of the remainder, about 250,000 people, have never been tested, and the goal is to test them first. Tests would be given at 40 designated sites, including clinics, community centers, churches and emergency rooms. Dr. Monica Sweeney, an assistant health commissioner for H.I.V. prevention, said the city had not set aside money specifically for the program, but would absorb the $12 cost of each test.

In organizing the campaign, which formally begins on Friday, Dr. Frieden has enlisted support from elected officials, health care providers and clergy members in the Bronx. But the proposal is raising some concerns.

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Restaurants Must Post Calories, Judge Affirms

Calorie counts must be posted alongside prices in some New York City restaurants, a federal judge ruled on Wednesday in upholding revised city regulations.

The restaurant association that lost on Wednesday said it would ask the judge to stay the ruling pending an appeal.

The decision, by Judge Richard J. Holwell of United States District Court in Manhattan, rejected First Amendment claims by the New York State Restaurant Association, which maintained that the mandatory labeling requirements were impermissible.

Under the rules, which the city’s health department revised after Judge Holwell struck down an earlier version last fall, any chain with at least 15 outlets nationwide would have to display calorie counts on menu boards, menus or food tags. The rules would apply to roughly 2,000 restaurants, or about 10 percent of the 23,000 in the city, the health department said.

In a 27-page opinion, Judge Holwell accepted one of the city’s main arguments for posting calorie counts — that doing so would help reduce obesity, which city officials say has reached epidemic levels.

“It seems reasonable to expect that some consumers will use the information” on menu boards and menus “to select lower-calorie meals,” the judge wrote. He added that “these choices will lead to a lower incidence of obesity.”

Some chain-restaurant outlets, among them Starbucks, have already posted calorie counts. The rules were scheduled go into effect on Monday. But the restaurant association said it was filing an appeal and would appear before Judge Holwell on Thursday to ask for a delay until after the appeal.

Chuck Hunt, a spokesman for the association, said it was disappointed in the ruling. He also said that it would cause “irreparable harm” to have to comply with the rules next week if they ended up being invalidated.

“We continue to say that each restaurant should make decisions about the best way to provide this nutritional information to their customers,” Mr. Hunt said. “Most of these restaurants that are being affected were already providing this information, but in a different format.”

But the city’s health commissioner, Dr. Thomas R. Frieden, called Judge Holwell’s decision “a victory for New Yorkers.”

“It will give people information they need, where they need it,” he said. “If you want to use it, great, and if you don’t, that’s entirely your right.”

The restaurant association maintained that the calorie rules violate the First Amendment because they force restaurants to convey a government message — “a message,” the judge noted in his decision, “with which they may disagree.”

The judge said the calorie counts required by the new rules are “reasonably related to the government’s interest in providing consumers with accurate nutritional information.” For that reason, he said, the rules do not infringe on restaurants’ First Amendment rights.

“The judge’s decision is crystal clear,” Dr. Frieden said. “They can go to court and delay us for a few more months, but if they do that, it just means McDonald’s and Kentucky Fried Chicken are desperate to keep this information out the hands of their customers.”

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