Effective September 2006, CDC has revised its recommendations for HIV testing in health-care settings. The Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings aims to make HIV testing a routine part of medical care in addition to expanding the gains made in diagnosing HIV infection among pregnant women. The Recommendations guide replaces the CDC's 1993 Recommendations for HIV Testing Services for Inpatients and Outpatients in Acute-Care Settings, and updates portions of the CDC's 2001 Revised Guidelines for HIV Counseling, Testing, and Referral and Revised Recommendations for HIV Screening of Pregnant Women.
What is different about the new Recommendations?
Key differences in the Recommendations for patients in all health-care settings are:
• HIV screening (another term for broad-based testing) for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
• HIV testing of people at high risk for HIV infection at least once a year.
• Screening should be incorporated into the general consent for medical care; separate written consent is not recommended.
• Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings.
Additional key differences in the Recommendations for pregnant women in health-care settings are:
• Including HIV screening in the routine panel of prenatal screening tests for all pregnant women, unless the patient declines (opt-out screening).
• Repeat screening in the third trimester in certain jurisdictions with elevated rates of HIV infection among pregnant women.
The Recommendations emphasizes the importance of voluntary testing.
Various constituencies have expressed concern that eliminating the recommendation for separate informed consent for an HIV test could result in some patients being tested for HIV without their knowledge. Others have asserted that requiring separate, written informed consent is a barrier that makes HIV screening difficult to conduct in heath-care settings, and that removing this requirement would make widespread HIV screening feasible.
Concerns have also been expressed over the lack of HIV prevention counseling in conjunction with HIV testing. The CDC continues to support prevention counseling as an intervention to help people reduce their risks for HIV, but recognizes it can become a barrier to HIV testing in busy health-care settings. The CDC still recommends that patients receive information about HIV testing, HIV infection, and the meaning of test results.
RDH eVillage's Director's question: Where do oral health settings fit into these recommendations?
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