CDC officials yesterday urged greater use of a rapid HIV test to identify newly infected people as early as possible, and so reduce their chances of transmitting the virus to others. The test can provide results in 20 minutes rather than the few days it takes for a standard HIV test. In many cases, patients who have taken the standard test have failed to return to learn the results, hampering efforts to control the epidemic. If positive, the results of the new test, in which a drop of blood is taken from a patient's finger, must still be confirmed by more specific laboratory methods.

Speaking at the 10th Conference on Retroviruses and Opportunistic Infections, Dr. Ronald Valdiserri, deputy director of CDC's National Center for HIV, STD, and TB Prevention, recommended that the new test be part of routine health care for those at risk for HIV infection. An estimated 280,000 of the 800,000 to 900,000 Americans living with HIV do not know they are infected, and the finger-stick test is intended to identify many of them. It is an important tool in the government's program to reduce by half, by 2005, the 40,000 new infections that occur annually.

All states report newly diagnosed AIDS cases, but not all report newly diagnosed HIV infections. That makes it difficult for health officials to track the progress of the epidemic. One worrisome fact is that for the first time in several years, the number of newly diagnosed AIDS cases increased slightly, up 1 percent in 2001, said Valdiserri. "It is still too early to know if this represents a reversal of previous AIDS trends," he said.

The increase is among the reasons CDC has been working with specialized groups to change the way people are counseled and tested for HIV. The agency recognized many barriers, like lack of reimbursement, that discourage doctors from spending the hour or so needed to counsel patients, said Valdiserri, adding that "risk reduction counseling should not be seen as the sole responsibility of the physician." Doctors, he said, can refer patients to other health care workers who can deliver sound prevention messages.

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