Government Wants Routine HIV Testing for Americans

Federal health recommendations announced Thursday say that all Americans between the ages of 13 and 64 should be tested regularly for HIV, and the testing should become as common as a cholesterol level check. Doing so would help doctors catch HIV infections earlier, and hopefully stop or at least slow the spread of the deadly virus. The federal recommendations aren’t legally binding—yet—but they will influence what doctors do and suggest to patients, and they will probably affect what health insurance programs cover.

CDC officials say that almost half of all new HIV infections are discovered by doctors when they are trying to diagnose the cause of a patient’s illness. Dr. Timothy Mastro, acting director of the CDC’s division of HIV/AIDS prevention, told reporters that the new guidelines are vital to facing the HIV/AIDS crisis head-on. "We know that many HIV infected people seek health care and they don’t get tested," Mastro said. "And many people are not diagnosed until late in the course of their illness, when they’re already sick with HIV-related conditions. By identifying people earlier through a screening program, we’ll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others."

The CDC has previously recommended routine testing for people who are at high risk for catching HIV/AIDS, including drug users and gay men, and has recommended routine testing in hospitals and certain other institutions in areas where HIV is common. The CDC also recommends routine testing for all pregnant women. Under the new guidelines, patients would be tested for HIV during routine physicals, and also as part of the standard battery of tests all patients receive when being treated for emergency or urgent care.

The announcement by the CDC was applauded by health policy experts and HIV patient advocates, who say that the guidelines may help end the stigma of HIV testing if everyone is having it performed. Routine testing may result in care being sought by the estimated 250,000 Americans who are infected with the disease and don’t know it.

Many physicians feel that the recommendations will be challenging to implement and will probably be costly due to increased time for testing, counseling, and the revision of consent procedures currently being used. Some question whether enough evidence exists to justify testing for HIV beyond high-risk groups. But the American Medical Association endorses the recommendations and has urged doctors to comply with them. The AMA’s statement about the guidelines said that they are an "important public health strategy to stop the spread of HIV."

CDC officials have been working on the recommendations for about three years and received input and feedback from more than 100 organizations including HIV patient advocacy groups and various medical associations. The final retooling of the guidelines strengthened the language about informed consent to ensure that no one will be tested without their knowledge.