CDC moves to put HIV testing into routine care

Waiving extensive pretest counseling is one way new recommendations could facilitate widespread screening.

By Victoria Stagg Elliott, AMNews staff. Oct. 16, 2006.

HIV testing shouldn't be considered special any more -- at least that's the take-home message of revised federal guidelines regarding HIV testing in health care settings.

According to new Centers for Disease Control and Prevention recommendations in the Sept. 22 Morbidity and Mortality Weekly Report, everyone ages 13 to 64 who receives health care should be offered an HIV test.

The CDC also recommends that specific written consent no longer be required, though patients should be informed that the test is being conducted and have the opportunity to decline. In addition, extensive prevention counseling is not necessary before performing the test or when delivering negative results.

"These new recommendations will make routine HIV screening feasible in busy medical settings where it previously was impractical," said Kevin Fenton, MD, PhD, director of CDC's National Center for HIV, STD and TB Prevention.

In this manner, the CDC's approach marks a shift in thinking. For much of its existence, HIV testing has been bound by special rules because of the associated stigma -- especially in the early days of the epidemic when physicians could offer little help to those who tested positive. Now, with the number of HIV treatments constantly expanding and the taint of the test diminished, public health officials believe that the benefits of widespread screening outweigh any risks.

"It is simply not acceptable for HIV-infected individuals to visit a health care facility without having the opportunity to learn that they have a life-threatening illness," Dr. Fenton said.