By Larry Tate
October 9, 2006

In late September, the CDC issued new recommendations for HIV testing in public and private health-care settings. The recommendation was for regular, routine testing for all Americans ages 13 to 64, making HIV testing as common as a cholesterol check. The recommendations aren’t legally binding, but they influence what doctors do and what health insurance programs cover.

The guidelines reflect an ongoing concern about the estimated 250,000 Americans who have HIV and don’t know it, first learning of the infection when the virus has made them sick. The administration of New York City Mayor Michael Bloomberg, for example, has for years tried to move toward the “normalizing of testing,” first offering the test in jails, then in clinics and hospitals. The campaign has resulted in a 50 percent increase in HIV tests in the city and a doubling of positive tests, allowing more people to begin preventive treatment before getting sick.

Under the new guidelines, patients would be tested for HIV as a matter of routine, when they go to the emergency room or even when they have a physical examination. Previously, the CDC had recommended routine testing only of high-risk groups, but too many people with HIV do not fall into these clear categories.

It is not known how widely these recommendations will be followed. In many areas where HIV is uncommon, doctors say that widespread testing would represent a waste of resources. Public health programs that pay for medical testing, already facing potential cuts, would be seriously stretched if they were required to provide HIV tests for the 200 million people this new recommendation would cover. Also, a number of laws around the country, requiring intensive counseling and confidentiality, would make it currently impossible to test everyone. It is thought that full implementation of the recommendations is unlikely in the near future.

Augusta (GA) Mayor Deke Copenhaver, who has been active in HIV issues for some time, was among the participants in a “media conference call” sponsored by the National Minority Health Month Foundation to present and discuss the new recommendations.