CDC Wants Routine AIDS Virus Testing

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http://apnews.myway.com/article/20060508/D8HFTCLOE.html

 

CDC Wants Routine AIDS Virus Testing

 

May 8, 7:37 PM (ET)

 

By MIKE STOBBE

 

 

ATLANTA (AP) - Testing for the AIDS virus could become part of routine

physical exams for adults and teens if doctors follow new U.S.

guidelines expected to be issued by this summer. Federal health

officials say they'd like HIV testing to be as common as a cholesterol

check.

 

The guidelines for voluntary testing would apply to every American

ages 13 to 64, according to the proposed plan by the U.S. Centers for

Disease control and Prevention.

 

One-quarter of the 1 million Americans with the AIDS virus don't know

they are infected, and that group is most responsible for HIV's

spread, CDC officials said.

 

" We need to expand access to HIV testing dramatically by making it a

routine part of medical care, " said the agency's Dr. Kevin Fenton.

 

CDC officials first disclosed the plans at a scientific conference in

February. Last week, they said the guidelines should be released in

June or July.

 

The recommendations aren't legally binding, but they influence what

doctors do and what health insurance programs cover.

 

Currently, the CDC recommends routine testing for those at high-risk

for catching the virus, such as IV drug users and gay men, and for

hospitals and certain other institutions serving areas where HIV is

common.

 

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 wouldn't 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 hospital's standard care consent form.

Patients would be allowed to decline the testing.

 

Standardizing HIV testing should reduce the stigma as well as

transmission, CDC officials said. Nearly half of new HIV infections

are discovered when doctors are trying to diagnose an illness in a

patient who has come for care, they noted.

 

The American Medical Association supports the proposed

recommendations, said Dr. Nancy Nielsen, a Buffalo, N.Y.-based

physician who is speaker of the AMA's House of Delegates.

 

Some doctor's offices will face challenges implementing the

recommendations, she added. For example, they should not give a

positive HIV test result over the phone and would have to provide or

arrange for counseling.

 

But the benefits of reducing the spread of HIV far outweigh the

logistical challenges, said Nielsen, an infectious disease specialist.

 

" I'm so happy the CDC is recommending this, " she said. " HIV is an

infectious disease and it should be treated like any other infectious

disease. The fact that it has been treated so differently, I think, in

some ways has contributed to the stigma. "

 

Some patients' advocates have voiced concern that the recommendations

do not include pre-test counseling and sufficient informed consent.

 

At many HIV testing sites, patients sit through a counseling session

to explain the procedure before any blood is drawn. Many centers also

require a patient to give " informed consent, " indicating they

understand the risks and benefits of the test.

 

The new recommendations, as currently drafted, do not require pre-test

counseling. They call for post-test counseling to be offered only to

patients who test positive.

 

CDC officials say they understand advocates' concerns, and are

optimistic physicians will follow the recommendations carefully.

 

" Doctors should be explicit that 'You're going to be tested,' " said

Dr. Tim Mastro, acting director of the CDC's division of HIV/AIDS

prevention.