Legal Barriers to Wide HIV Testing Now Mostly Gone

HIV testing laws in most states are now compatible with CDC recommendations to streamline diagnosis of the virus, according to a new report. Five states still have testing laws incompatible with at least one aspect of CDC's 2006 HIV testing recommendations, down from 16 states in 2009. The data are based on the January 2011 update to the Compendium of State HIV Testing Laws.

In 2006, CDC recommended HIV screening in health care settings for all patients ages 13-64 unless they specifically decline the test. The agency advised that general consent to medical care include the offer of HIV testing -- whereas some states required separate, written consent solely for HIV testing -- as well as streamlined pre- and post-test counseling.

Since then, 24 states have changed their laws to embrace CDC's recommendations, according to Sarah Neff, MPH, and Ronald Goldschmidt, MD, of the University of California-San Francisco. As of the January update to the compendium, 46 states and jurisdictions (including District of Columbia) had laws that were compatible with CDC's HIV testing guidance.

The five states whose HIV testing laws remain incompatible are Maine, New York, Nebraska, Pennsylvania, and Rhode Island, reported Neff and Goldschmidt. Maine requires opt-in testing, in which patients must expressly request an HIV test. Pennsylvania and Rhode Island have counseling requirements that are at odds with CDC recommendations.

Maine and Nebraska both mandate separate HIV testing consent and they, together with New York and Pennsylvania, also require written rather than oral consent. New York does allow oral consent for rapid HIV testing.

The full report, "Centers for Disease Control and Prevention 2006 Human Immunodeficiency Virus Testing Recommendations and State Testing Laws," was published in the Journal of the American Medical Association (2011;305(17):1767-1768).

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