Second Peace Corps volunteer reports being discharged after testing HIV-positive, Washington Post reports

May 19 2008

Washington Post columnist Stephen Barr on Friday examined the case of a second Peace Corps volunteer who said she was discharged from service after testing HIV-positive. Rebecca Coulborn, a former volunteer in Burkina Faso, said she was required to leave her post immediately in 2001 after she tested positive for the virus.

Coulborn spoke about her case after reading an April 28 Post article on former Peace Corps volunteer Jeremiah Johnson, who was discharged from his post in Ukraine after he was diagnosed with HIV.

In a May 7 letter responding to a previous letter from the American Civil Liberties Union, the Peace Corps said Johnson was the first case of a volunteer "to our knowledge" who wanted to continue service after testing HIV-positive, the Post reports.

However, Coulborn, an epidemiologist at the University of Michigan, said that she "did not want to be medically separated" from the agency. According to Coulborn, she was told that it was "Peace Corps policy. If you did test HIV-positive, you were medically separated" from service. She said, "I really thought it was their policy to automatically separate people" with HIV/AIDS, adding, "I felt for a long time that this was something done to me that was wrong, and very unethical."

During her Peace Corp service, Coulborn provided health education in a village of 800 people in Burkina Faso. She said she thinks she contracted HIV when helping a person who had been injured in a bicycle accident. According to Barr, Coulborn did not expect her HIV-positive test result. However, Barr writes that Coulborn was more surprised when the local agency medical officer, following instructions from headquarters, told her "to pack up [her] stuff and not expect to return."

Coulborn said that she remains in good health and has not had to start antiretroviral therapy, adding that she believes she "could have completely and totally served out my term as a Peace Corps volunteer." Being forced to leave her assignment "was devastating," she said, noting that her departure ended ongoing and upcoming projects for the village. "Testing positive for HIV should not disqualify you from serving your country internationally," Coulborn said.

Amanda Beck, Peace Corps press director, said the statement about Johnson being the first volunteer who wanted to continue his service was "based on personal knowledge of the currently serving Peace Corps staff members," who generally turnover every five years under the agency's staffing policies. "Our primary concern is that Peace Corps volunteers receive the best medical care and treatment possible," Beck said, adding, "In the case of HIV, the Peace Corps Office of Medical Services has historically determined that the best testing, evaluation and treatment for volunteers is available from specialists in the United States." Beck said that 75,000 U.S. citizens have served in the Peace Corps since 1989 and that 36 have tested HIV-positive during or at the close of their service.

Under a Peace Corps general policy, if a volunteer develops a medical condition that cannot be resolved within 45 days, he or she is medically separated from the agency. Initial evaluation and treatment for HIV can take from three to six months -- meaning that Peace Corps volunteers who are HIV-positive experience what ACLU calls automatic separation, Barr writes.

According to Barr, the Peace Corps in its letter to ACLU said that its policy "appears to be evolving." The letter said that the agency "is now committed to extending the individualized assessments in these types of cases to include whether a newly infected volunteer could be reasonably accommodated and either kept at post or sent to another post in lieu of medical separation." It added that it "cannot commit to a guarantee of reassignment" (Barr, Washington Post, 5/16).