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AIDS testing for ALL.
Have You Had Your AIDS Test? Why
The U.S. Centers for Disease Control and Prevention said HIV testing should become about as common as a cholesterol check. Nearly half of new HIV infections are discovered when doctors are trying to diagnose a sick patient who has come for care, CDC officials said.
We know that many HIV infected people seek health care and they dont get tested. And many people are not diagnosed until late in the course of their illness, when theyre already sick with HIV-related conditions, said Dr. Timothy Mastro, acting director of the CDCs division of HIV/AIDS prevention.
By identifying people earlier through a screening program, well allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others, he said.
The announcement was hailed by some HIV patient advocates and health policy experts. They said the guidelines could help end the stigma of HIV testing and lead to needed care for an estimated 250,000 Americans who dont yet know they have the disease.
I think its an incredible advance. I think its courageous on the part of the CDC, said A. David Paltiel, a health policy expert at the Yale University School of Medicine.
The recommendations arent legally binding, but they influence what doctors do and what health insurance programs cover.
Some physician's groups predict the recommendations will be challenging to implement, involving new expenditures of money and time for testing, counseling and revising consent procedures.
Some physicians also question whether there is enough evidence to expand testing beyond high-risk groups, said Dr. Larry Fields, the president of the American Academy of Family Physicians.
Are doctors going to do it? Probably not, Fields said.
But the recommendations were endorsed by the American Medical Association, which urged physicians to comply.
This is important public health strategy to stop the spread of HIV, Dr. Nancy Nielsen, a Buffalo, N.Y.-based physician who sits on the AMAs governing board, said in a statement.
No consent form needed
Previously, the CDC recommended routine testing for those at high-risk for catching the virus, such as intravenous drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommends testing for all pregnant women.
Under the new guidelines, patients would be tested for HIV as part of a standard battery of tests they receive when they go for urgent or emergency care, or even during a routine physical.
Patients wouldnt get tested every year: Repeated, annual testing would only be recommended only for those at high-risk.
There would be no consent form specifically for the HIV test; it would be covered in a clinic or hospitals standard care consent form. Patients would be allowed to decline the testing.
CDC officials have been working on revised recommendations for about three years, and sought input from more than 100 organizations, including doctors associations and HIV patient advocacy groups. The CDC presented planned revisions at a scientific conference.
Since then, the CDC has strengthened language on informed consent
to make sure that no one is tested without their knowledge, and
emphasized the need for doctors to provide information on HIV tests
and the meaning of positive and negative results.