Routine HIV Tests Endorsed by CDC

HIV testing should become a routine part of medical care, especially for pregnant women unless they specifically request otherwise, CDC said Thursday. The recommendations to state health departments, which are not legally binding, form part of a new strategy aimed at preventing HIV transmission by people who do not know they are infected. The strategy places HIV on a par with other health problems -- such as high cholesterol -- for which people are screened once they are suspected to be at risk.

"Each year we continue to see about 40,000 new HIV infections domestically," said CDC Director Dr. Julie Gerberding. "We have well over 800,000 people living with HIV in our country, but an estimated 200,000 of these people do not know they are infected. ... This is an intolerable situation," she said.

The strategy has four main components:

• Routinely offering HIV tests as part of medical appointments in high HIV-prevalence locations, or when personal background makes it likely patients are at high risk.
• Making 20-minute rapid HIV tests available in nonmedical settings such as jails and homeless shelters. These recently approved tests are mostly used in medical institutions.
• Tracing the partners of those found to be HIV-infected and offering them testing and training in prevention.
• Making HIV one of the conditions for which pregnant women are checked, unless they specifically refuse to be tested, and encouraging testing of all newborn children. About 300 children are born with HIV in the United States each year. CDC did not specify whether newborn testing should be mandatory.

Jeff Graham, executive director of the Atlanta-based AIDS Survival Project, said he is concerned that CDC's HIV testing program downplays counseling, ignores needle exchange programs, and could lead to coercive testing of prisoners and pregnant women. Giving the rapid HIV test with little or no counseling could take away opportunities to explain low-risk behaviors and to refer newly diagnosed people to good treatment programs, Graham said. Marc Isaac, vice president of the Elizabeth Glaser Pediatric AIDS Foundation in New York, applauded the prenatal testing emphasis, but cautioned that women should retain the right to refuse the test for themselves and their infants. The recommendations can be found here.

Back to other CDC news for April 18, 2003

Previous Updates