This is interesting. The CDC seems to be suggesting pretty drastic changes in HIV screening procedures:

For patients in all health-care settings

  • HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed 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 should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
  • Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings.

For pregnant women

  • HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
  • HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
  • Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
  • Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.

This is a pretty big change. Later in this document they say:

These revised CDC recommendations advocate routine voluntary HIV screening as a normal part of medical practice, similar to screening for other treatable conditions. Screening is a basic public health tool used to identify unrecognized health conditions so treatment can be offered before symptoms develop and, for communicable diseases, so interventions can be implemented to reduce the likelihood of continued transmission (30).

They also point out that the cost of screening has dropped, making a more comprehensive approach feasible.

What impresses me the most though, is that they are recommending this for all patients unless the clinician can document an HIV prevalence in his patient population less than 0.1%! They are really saying that this should now be a routine procedure in everyone unless they specifically opt out of the process.

Personally, I think it’s about time. HIV should be treated like other communicable diseases, especially now that the stigma of affliction is less and therapy is more effective.

More later …

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