30-Plus States Bar Routine HIV Testing Recommended by U.S. Health Officials

A year after CDC issued new guidelines aimed at making HIV testing a part of routine health care, a new study finds that more than 30 states still have laws on the books that prevent doctors from adopting those recommendations. CDC's guidelines would relieve doctors of the requirement that they conduct pre-test counseling and obtain the patient's specific informed consent for the test. When the agency issued its recommendations, however, it acknowledged that state laws might be an obstacle. The new study illuminates the extent to which state laws are a barrier to making HIV testing routine. The researchers -- whose results are current through July and do not include proposed legislation -- examined state laws and recent amendments using legal databases. According to the report, 33 states continue to require informed consent for an HIV test. Twenty-four states require that information about HIV/AIDS and the test be presented either in pretest counseling or during the consent process. Only two states -- Rhode Island and Illinois -- took action with the declared intention of complying with CDC's guidelines. Both, however, left in place some form of informed consent or pretest counseling, said Leslie Wolf, the lead author and an associate professor of law at Georgia State University. Dr. Bernard Branson in CDC's HIV/AIDS prevention division said more states are moving forward on the recommendations. He said seven states -- Illinois, Iowa, Indiana, Louisiana, Maine, New Hampshire and New Mexico -- have modified their laws to better conform to the guidelines. California will become the eighth state to do so if Gov. Arnold Schwarzenegger signs a bill passed by the Legislature last month. Branson acknowledged that tracking the changes is difficult because the laws are subject to multiple interpretations. The full study, "Implementing Routine HIV Testing: The Role of State Law," was published today in the online journal PLoS One.

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