CDC urges routine HIV tests

HIV testing should be part of routine health screening for Americans ages 13 to 64, according to Centers for Disease Control and Prevention recommendations released Thursday. Emphasis is also being placed on routine testing for pregnant women.

The goal is to prevent spread of the deadly virus and to detect HIV infection early, before people have developed related conditions, so they can be treated appropriately and quickly, the CDC says.

The CDC estimates that of the 1 million to 1.2 million Americans infected with HIV, one-fourth do not know and thus don't get treatments that could help minimize the impact of the infection. And some of them, it says, "are likely to have transmitted HIV unknowingly."

The recommendations are voluntary and come with an opt-out provision so that patients can tell the doctor they don't want to be screened for HIV. For those at high risk, screening should be annual. For others, after the initial screening, the timing of additional testing is something for doctor and patient to decide.

The CDC made it clear as early as 2001 that it would like to see HIV testing become as routine as glucose or cholesterol screening.

"It's kind of cool to see it actually coming to fruition," says Rebecca Fronberg, HIV counseling and testing coordinator for the Utah Department of Health. "But I think there are lots of concerns and questions from people who feel they're not at risk."

Fronberg warns that people don't always have a realistic sense of their risk. She has seen cases where a spouse has not been faithful or honest, putting the unknowing partner at risk. "I think all people should have at least one (HIV test) in their life, especially people who consider themselves not at risk," she says.

While a number of different groups were hailing the recommendations, they say they may be challenging to implement.

"I think it's important to normalize HIV testing," says David Ferguson, Utah AIDS Foundation programming director, "but there are concerns with blanket testing."

Ferguson worries first that the counseling component that has been a part of screening for HIV/AIDS will disappear. "If this does happen where it becomes a routine part of a physical exam, counseling is probably not going to happen. And we've had an opportunity to do some really good education and prevention within that screening process."