9.21.06 - San Francisco AIDS Foundation Supports the CDC's Move to Make HIV Testing Routine

The San Francisco AIDS Foundation (SFAF) announces its support for revised recommendations issued today by the Centers for Disease Control & Prevention (CDC) that seek to make HIV testing a routine part of medical care for adults, adolescents, and pregnant women aged 13 to 64 in health care settings. The recommendations do not apply to non-clinical settings such as publicly funded HIV test sites and community clinics where testing is not ordered by a physician.

The revised recommendations seek to address the 25 percent of Americans the CDC estimates are HIV-positive and do not know it, jeopardizing their own health and the health of their sex and needle sharing partners. Mark Cloutier, Executive Director of the San Francisco AIDS Foundation said: "The current testing paradigm has failed to identify the 250,000 Americans who need to be in care for HIV infection from getting care. Many of the 40,000 new cases of HIV infection that occur nationally each year could also be avoided if more HIV-positive people were encouraged to learn their HIV status. Removing barriers to HIV testing, while providing safeguards for informed consent and maintaining confidentiality will reduce new infections in the United States."

Since 1985 when the test for HIV infection first became available, Americans have been encouraged to be tested, but testing has been focused on high-risk individuals who stepped forward to learn their HIV status. The revised recommendations promote a move toward population-wide screening of all adults in a vigorous effort to identify previously undiagnosed cases of HIV. Under the revised recommendations, all adult patients would be informed that an HIV test is considered a part of routine health care, have the meaning of both a positive and negative test result explained, and have a right to opt-out of testing.

Cloutier said "We welcome and support this shift. It is apparent that we will not achieve greater success in treating HIV and preventing new cases of HIV if we are not willing to adopt new approaches to testing."

The new recommendations eliminate both pre-test counseling and separate written consent, which Cloutier believes have discouraged HIV testing for many at-risk individuals. "Not only do these steps present a barrier to testing for people who may be at risk for HIV infection, but the time and paperwork they require discourages many physicians and medical providers from even discussing the importance of HIV testing with patients."

Cloutier added that the revised recommendations must be accompanied by an increased commitment on the part of the federal government to assure the availability of primary medical care and treatment for those Americans who are diagnosed with HIV. "Existing funds are inadequate to fully meet the cost of care and treatment for individuals already known to be HIV-positive. The nation must not abandon the many people who will learn that they are HIV-positive under this new initiative. I am particularly concerned about access to care and treatment for immigrants and low-income people." Studies show that people who get tested earlier in the disease cycle live longer, healthier lives than people who learn their status later. Today, nearly 40 percent of people diagnosed with HIV receive that diagnosis within one year of developing AIDS.

The CDC has indicated that it still must propose guidelines for implementing its revised recommendations. Cloutier said the San Francisco AIDS Foundation will review the proposed guidelines to make sure that they guarantee individuals' rights to be informed if an HIV test is to be performed, to have the meaning of the test and its results explained, and to opt-out of testing if they so choose.