HIV Testing Should Be Incorporated into Routine Care
Everyone should be tested for HIV as part of routine medical care, the Centers for Disease Control and Prevention (CDC) recommends, but state law hasn’t caught up.
Senate Bill 291, introduced by Sen. Ted Erickson (R-Delaware), would update state law so it is consistent with the CDC recommendations. The bill is currently in the Senate Public Health and Welfare Committee.
The Pennsylvania Medical Society’s House of Delegates at its 2008 meeting passed a series of resolutions recommending that state law be changed to reflect the CDC guidelines.
Rather than targeting high-risk groups, the CDC now recommends that everyone between 13 and 64 years old be tested. Consent for testing should be given with consent for routine medical care, allowing patients the chance to opt out.
“We continue to have 40,000 to 60,000 new cases of HIV each year. Trying to target-test high-risk populations and get them to reduce their risky behaviors has not worked,” said Allentown infectious disease specialist and Pennsylvania Medical Society member Margaret Hoffman-Terry, MD.
“Twenty-five percent of those with HIV don’t know they have the disease and are responsible for 50 to 70 percent of new infections,” Dr. Hoffman-Terry said. The new guidelines aim to reduce those numbers.
Although the new guidelines were released in 2006, Pennsylvania law still requires a separate signed consent for HIV testing in conjunction with pre- and post-test counseling.
“It really becomes a very onerous process, especially if you’re suddenly saying ‘We want to test everybody,’” Dr. Hoffman-Terry said.
The state law was enacted to protect patients when “HIV was a very different disease,” Dr. Hoffman-Terry said.
With the advent of HIV drug cocktails in the mid-1990s, HIV has become a chronic, manageable disease. It is most often spread through heterosexual contact and patients survive 20 to 30 years from diagnosis, rather than just a few years.
Last Updated: 9/15/2009