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Background

Consistency of State Statutes With the Centers for Disease Control and Prevention HIV Testing Recommendations for Health Care Settings. Anish P. Mahajan , MD, MPH; Lara Stemple , JD; Martin F. Shapiro, MD, PhD; Jan B. King, MD, MPH; and William E. Cunningham, MD, MPH

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  1. Consistency of State Statutes With the Centers for Disease Control and Prevention HIV Testing Recommendations for Health Care Settings Anish P. Mahajan, MD, MPH; Lara Stemple, JD; Martin F. Shapiro, MD, PhD; Jan B. King, MD, MPH; and William E. Cunningham, MD, MPH Ann Intern Med. 2009;150:263-269.

  2. Background • Over the past decade, Centers for Disease Control and Prevention (CDC) recommendations have evolved from risk-assessment– based testing to “routine voluntary counseling and testing” for all adults in all health care settings. Despite the revised guidelines, low HIV screening rates persist.

  3. Background • In September 2006, the CDC recommended a new paradigm for HIV testing: opt-out HIV screening for all patients in all health care settings . In the CDC’s version of opt-out testing, the provider notifies the patient that HIV testing will be performed and offers the patient the opportunity to ask questions and to decline testing. In this paradigm, separate written consent and prevention counseling are not required for HIV testing.

  4. Mehod • The 2006 CDC “Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-care Settings” contain substantive changes to 3 components of the standard HIV testing process: consent for testing, pre- and posttest counseling, and method of offering screening to adults and pregnant women.

  5. Conclusion • Multiple analyses indicate that HIV screening according to the CDC recommendations are cost-effective. Misinterpretation of the CDC recommendations and inaccurate generalizations about state statutes should not derail implementation. Although many critics have voiced concern about potential statutory barriers, state statutes that govern HIV testing are in fact increasingly compatible with implementation of the CDC recommendations.

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