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1993.03.04 :  HIV Testing in Hospitals

Contact: PHS - Rayford Kytle (202) 690-6867
CDC - (404) 639-3286  
March 4, 1993

       The federal government recommended today that hospitals in
areas with significant numbers of HIV/AIDS cases routinely offer
HIV testing to most patients.
       Testing would be voluntary but would be offered to all
people, aged 15 to 54, admitted as patients or treated as
outpatients in these hospitals.  Under the guidelines, all
results would be confidential and people who refused testing
would still be given full medical care.
        The Recommendations for HIV Testing Services for
Inpatients and Outpatients in Acute-Care Hospital Settings were
made available by the Centers for Disease Control and Prevention
in Atlanta, a U.S. Public Health Service agency, based on new
data that would indicate that many unrecognized HIV infections
would be revealed by such hospital-based testing.  
       HHS Secretary Donna E. Shalala said, "These
recommendations will help people learn of their HIV status and
get early treatment to delay the disease and prolong their lives. 
Knowing their status, they will also be able to take precautions
to protect loved ones."
       CDC studies indicate HIV infection rates as high as 8.9
percent among persons receiving care in some emergency rooms and
as high as 7.8 percent among hospitalized people.  (In the
hospitals surveyed, rates were as low as 0.2 percent and 0.3
percent, respectively.)  CDC's surveys used anonymous blood
samples.  Hospitals could learn their own rate by similar
anonymous testing.  Other studies indicate as many as 65 percent
of HIV positive patients were not aware of their HIV status. 
       The new recommendations call for hospitals to "strongly
consider" offering HIV counseling and testing routinely to
patients aged 15-54 years if the prevalence rate is higher than 1
percent, or one in a thousand discharged patients have AIDS. 
Patients in this age range at these hospitals account for about
68 percent of HIV infected persons hospitalized in the United
States for conditions other than HIV/AIDS.
       CDC recommends all acute-care facilities encourage health-
care providers to routinely ask patients about their risks for
HIV infection and offer HIV counseling and voluntary testing
services to patients at risk.  CDC also encourages other health-
care institutions such as drug treatment centers and private
medical practitioners to consider offering these services. 
       The counseling and testing procedures should be structured
to:
     o    facilitate confidential, voluntary patient        
          participation;

     o    include pretest information on the testing policies
          of   the institution or physician;

     o    provide basic information about the medical       
          implications of the test;

     o    give patients the option to receive more information;
          and

     o    document informed consent of the patient.
 
       CDC also released Technical Guidance on HIV Counseling,
which supplements Public Health Service Guidelines for Counseling
and Antibody Testing to Prevent HIV Infection and AIDS published
in August 1987.                  


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