CDC calls for routine testing to stem HIV infection rates

While the guidelines should increase the number of patients tested, there are concerns about inadequate pretest counseling.

By Victoria Stagg Elliott, AMNews staff. May 19, 2003.

In the past three years, Marshall Kubota, MD, a Santa Rosa, Calif., family physician, has had four patients die of AIDS-related complications. Two of them received the AIDS diagnosis on their hospital deathbeds.

Stories like this are part of the motivation behind the Centers for Disease Control's new HIV prevention guidelines published last month in the Morbidity and Mortality Weekly Report.

According to the guidelines, HIV testing should be like any medical screen or test provided by a primary care physician, and pretest counseling should be simplified to work in this setting. Testing should also be routine for pregnant women or their newborns if the mother has never been tested.

Ways should be found to utilize the rapid-results test outside the medical setting, and public health prevention messages should be targeted to people who are already HIV-positive in an effort to stop the infection's spread.

"This new initiative is exciting and it capitalizes on new, rapid testing technologies, provides us the opportunity to reduce barriers to testing, enhances prevention services and continues to prevent mother-to-child HIV infections," said Harold Jaffe, MD, director of the CDC's National Center for HIV, STD and TB Prevention.

The CDC is attempting to address what public health officials believe are the major obstacles to improving AIDS morbidity and mortality. AIDS-related deaths plummeted in the mid-1990s after the introduction of anti-retrovirals, but this progress has since plateaued. New infections also appear to be inching upwards.