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New CDC HIV Testing Guidelines for Adults and Adolescents
Routine HIV screening should now be offered at all points of care to all individuals aged 13 to 64, regardless of their potential risk for infection.
The CDC recently revised its recommendations for HIV testing, urging routine screening on an opt-out basis for all individuals aged 13 to 64, regardless of potential risk. Testing is to be offered at all points of care, from routine medical appointments to emergency visits to prison intake. Annual screening is recommended for individuals at high risk, and pregnant women are to be rescreened in the third trimester if they are at high risk or living in areas with high HIV prevalence. The guidelines also stipulate that consent for HIV testing should be considered as part of general consent for medical care; pretest counseling and separate, written consent for HIV testing should no longer be required.
These revised recommendations are aimed at identifying the estimated 252,000 to 312,000 people in the U.S. who are unaware of their HIV infection. One hopes that the "normalization" of HIV screening not only will offer such individuals access to testing and care before they get sick but also will destigmatize HIV testing and, ultimately, HIV disease. However, transforming these recommendations into action will require overcoming some substantial hurdles, not the least of which are state laws currently governing written informed consent for HIV counseling and testing, lack of reimbursement for provision of these services, the additional time such testing will add to each clinical visit, and the effort required to reach and convince diverse communities of healthcare providers to offer HIV testing on a routine basis.
— Judith Feinberg, MD
Published in AIDS Clinical Care December 29, 2006