HIV testing rates have remained fairly stable from 2001 through 2006. Ten percent of adults age 18-64 report getting tested each year (approximately 18 million people in 2006) but the percentage of people who report ever being tested in their lifetimes has not increased—it remained stable from 2001 to 2006 at about 40% (an estimated 71.5 million people in 2006). Specifically, in 2006, 22% of blacks, 13% of Hispanics, and 8% of whites reported being tested for HIV in the preceding 12 months. Among persons with HIV risk factors, the percentage who were tested in the past year was more than twice as high (23%) than among people without risk factors (10%), but 77% of persons with HIV risk factors were not tested in the preceding 12 months.

According to the survey, 61% of pregnant women reported an HIV test in the preceding 12 months, compared with 13% of non-pregnant women. That percentage is considerably lower than for other infectious diseases, even though CDC has recommended HIV testing for all pregnant women since 1995. By comparison, rates of prenatal screening were greater than 95% for hepatitis B, rubella, and syphilis during 1998-1999.

The report is based on the National Health Interview Survey (NHIS), an annual household survey of a representative sample of the U.S. population that provides estimates for a broad range of health measures. The NHIS is administered by CDC’s National Center for Health Statistics (NCHS). For more information, please visit the NHIS Web site.

These testing data will serve as a baseline for monitoring the impact of CDC’s 2006 HIV testing recommendations and other new initiatives to increase testing. In 2006, CDC released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings to encourage HIV screening as part of routine medical care for all persons aged 13-64 years. These recommendations aimed to simplify HIV testing procedures and eliminate counseling as a barrier to HIV testing. In 2007, as part of the President’s Domestic HIV Initiative, CDC allocated $35 million to 23 jurisdictions to expand testing in clinical settings, primarily among African Americans. In addition, CDC’s Heightened National Response to the HIV/AIDS Crisis among African Americans (HNR) is pursuing various efforts to increase HIV testing.

Yes. The NHIS is only one of several data sources that could be used for assessing the impact of large-scale testing initiatives at the national level. Another national household survey sponsored by NCHS that includes HIV testing questions is the National Survey of Family Growth. CDC also sponsors the Behavioral Risk Factor Surveillance System, which is a state- and population-based telephone survey that asks about HIV testing. CDC provides support to the General Social Survey, a national household survey conducted every 2 years by the National Opinion Research Council; questions about HIV testing were first included on that survey in 2006. In addition to these population-based surveys, CDC has established two other national data collection systems that will be able to evaluate trends in HIV testing behaviors in the near future. The National HIV Behavioral Surveillance (NHBS) System, which began in 2003, is designed to provide better nationally representative estimates for behaviors among MSM, IDUs, and high risk heterosexuals. The Program Evaluation and Monitoring System (PEMS) is designed to monitor programmatic activities, including HIV testing services, provided by prevention agencies either directly funded by CDC or indirectly funded through state or local health departments.

Yes. Nearly 18 million people are being tested for HIV each year. In 2006, testing rates were higher for pregnant women, persons who reported HIV risks, young persons (ages 18-34), and African Americans than for other groups. This suggests that testing efforts have reached many of the people disproportionately affected by HIV. However, expanded and innovative efforts have been needed to increase testing. In recent years, CDC has been developing new strategies to reach persons at risk for HIV who have not received HIV tests. Examples include social marketing campaigns designed to increase knowledge of HIV status and promote HIV risk reduction, such as Take Charge. Take the Test for African American women, and One Test, Two Lives for pregnant women.

HIV testing is critical to any comprehensive HIV prevention program. An estimated quarter of a million people who are infected with HIV don’t know they are infected. Research shows that when people learn they are infected with HIV, they take steps to protect their health and the health of their partners. Additionally, the earlier a person is diagnosed, the sooner he or she can access medical care and other prevention services to further prevent transmission and disease progression.

All health-care settings should adopt the 2006 CDC testing recommendations and routinely screen all patients age 13-64 years for HIV. Health-care providers should also encourage annual HIV testing for all individuals with known risks for HIV, especially sexually active men who have sex with men (MSM) and others engaging in HIV-related