New Recommendations for HIV Testing

The U.S. Centers of Disease Control and Prevention (CDC, Atlanta, GA, USA) have revised their recommendations for human immunodeficiency virus (HIV) testing, now advocating routine voluntary HIV screening as a normal part of medical practice, similar to screening for other treatable conditions. HIV screening would be routine in all medical settings for patients from the ages of 13 to 64.

Effective September 2006, the "Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Healthcare Settings” aim to make HIV testing a routine part of medical care in addition to expanding the gains made in diagnosing HIV infection among pregnant women. The recommendations replace the CDC's 1993 recommendations and they update portions of the 2001 revised guidelines.

The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in healthcare settings; to foster earlier detection of HIV infection; to identify and counsel people with unrecognized HIV infection and to link them to clinical and prevention services; and to further reduce perinatal transmission of HIV in the United States.

The HIV-testing recommendations are intended for all healthcare providers in the public and private sectors, including those working in hospital emergency departments, urgent care clinics, inpatient services, substance-abuse treatment clinics, public health clinics, community clinics, correctional healthcare facilities, and primary care settings. The recommendations address HIV testing in healthcare settings only. They do not modify existing guidelines concerning HIV counseling, testing, and referral for people at high risk for HIV who seek or receive HIV testing in nonclinical settings (e.g., community-based organizations, outreach settings, or mobile vans). HIV screening will be included in the routine panel of prenatal screening tests for all pregnant women.

HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening). People at high risk for HIV infection should be screened for HIV at least annually. Separate, written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing. Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.



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Centers of Disease Control and Prevention