On April 17, 2003, the Centers for Disease Control and Prevention (CDC) announced a new initiative, “Advancing HIV Prevention (AHP): New Strategies for a Changing Epidemic.” Its goals include making HIV testing a routine part of medical care and implementing new models for diagnosing HIV infections outside medical settings.
In September 2006, CDC released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. These new Recommendations replace CDC's 1993 Recommendations for HIV Testing Services for Inpatients and Outpatients in Acute-Care Hospital Settings, and they update aspects of CDC's 2001 Revised Guidelines for HIV Counseling, Testing, and Referral that apply to health care settings and the 2001 Revised Recommendations for HIV Screening of Pregnant Women.
The revised Recommendations are the result of years of consultations, collaborations, and communications between CDC and its many partners and constituents. These Recommendations are intended for all health care providers in the public and private sectors working in settings where other diagnostic and screening tests are performed routinely. These settings include hospital emergency departments, urgent care clinics, inpatient services (including labor and delivery), substance abuse treatment clinics, public health clinics, community clinics, correctional health care facilities, pediatric and adolescent care clinics, prenatal care clinics, and other primary care settings. The Recommendations do not apply to non-medical settings, such as mobile HIV testing vans.
Major revisions from previously published guidelines include:
- HIV screening is recommended for all patients ages 13-64 in all health care settings after the patient is notified that testing will be done unless the patient declines (opt-out screening).
- Persons at high-risk for HIV infection should be screened for HIV at least annually.
- Separate written consent for HIV testing is not recommended; general consent for medical care should be sufficient to encompass consent for HIV testing.
- Prevention counseling should not be required with HIV diagnostic testing or as part of routine HIV screening programs in health care settings.
- HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women, and HIV screening is recommended after the patient is notified that testing will be done unless the patient declines (opt-out screening).
CDC is also in the process of updating recommendations for HIV testing in non-health care settings, with publication expected in 2007.