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In September, the Centers for Disease Control and Prevention (CDC) recommended that all Americans between ages 13 and 64 undergo routine screening for HIV infection. The old guidelines, in effect since 1993, called for testing only those at high risk for HIV infection.
Under the new guidelines:
* routine HIV screening is recommended for patients in all health care settings
* screening is still voluntary, but specific written consent isn't required; a facility's general consent for medical care would encompass HIV screening.
* pretest counseling is no longer required.
* HIV screening should be included in the routine panel for prenatal screening tests for all pregnant women. Repeat screening in the third trimester is recommended in areas where HIV rates are high.
An estimated 25% of adults with HIV don't know that they're infected. The new guidelines aim to help clinicians diagnose more people earlier and to simplify the testing process. New infections could be reduced by 30% annually if people who know they're HIV-positive changed high-risk behaviors, CDC officials estimate.
Health care providers aren't legally required to follow the new guidelines, and the added time and costs involved in expanded screening may be a barrier to implementation. But insurance companies are more likely to cover routine HIV screening that's recommended by the CDC.
For more about current HIV screening guidelines, visit the National Center for HIV, STD, and TB Prevention at http://www.cdc.gov/nchstp/od/nchstp.html.
Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings, Morbidity and Mortality Weekly Report-Recommendations and Reports, BM Branson, et al., September 22, 2006.
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