Good Recommendation from CDC

All patients aged 13 to 64 should be screened for HIV routinely, according to new guidelines from the CDC. Nearly 250,000 Americans are estimated to have undiagnosed HIV.

The key aspects of the new recommendations, which are focused exclusively on healthcare settings, include:

-- All adult and teen patients should be screened, regardless of risk.

-- The screening approach should be voluntary "opt out" rather than "opt-in."

-- Specific HIV pretest counseling and separate, written informed consent should not be necessary, but should be incorporated in general consent for medical care (state and local laws allowing).

The guidelines also include steps to further reduce perinatal transmission. Pregnant women in high-prevalence areas, as well as those considered to be at high risk, should receive a second HIV test in the third trimester. Jurisdictions with high HIV prevalence among women as of 2004 were: Alabama, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Illinois, Louisiana, Maryland, Massachusetts, Mississippi, Nevada, New Jersey, New York, North Carolina, Pennsylvania, Puerto Rico, Rhode Island, South Carolina, Tennessee, Texas, and Virginia.

The guidelines reiterate that women with unknown HIV status at the time of delivery should receive rapid HIV testing.

Asked to comment, Dr. Carlos del Rio, associate editor of AIDS Clinical Care, said that "normalizing HIV testing is something that needed to happen." He added that in the past decade "advances in therapy have allowed us to provide care for HIV-infected individuals, but diagnosing these people remains elusive because AIDS exceptionalism has made testing for HIV different than for other diseases. These new guidelines will help in breaking those barriers."

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