The Washington State Board of Health recently revised its HIV counseling and notification rules, hoping to reduce testing barriers and reach those who are HIV-infected but do not know it.

"Our goal is to dramatically increase testing and make it more routine," said Tom Locke, chairperson of the board. "To do that we needed to drastically revise the rules."

The new rules allow physicians to consider a patient's history and tailor counseling accordingly. Previously, doctors were required to give patients extensive information about HIV before every test, even if the patient had tested before.

The rules also make local health agencies, rather than physicians administering the test, responsible for notifying the sexual partners of people who test HIV-positive. Partner notification was a burden to doctors, who often responded by directing patients to local agencies for HIV testing, said John Peppert, manager of the state Department of Health's HIV prevention program. "This isn't a bad thing, but every time you add a step there will be less people going to get tested," said Peppert.

More than 15,000 HIV infections have been reported in Washington since 1982, and health officials believe more than 3,000 people in the state are infected but do not know it. "Today the rate of new cases of infection is likely going up," said Locke, "but we can't be certain unless people get tested."

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