This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (12)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • HIV/AIDS  • Medical Practice  • Law and Medicine  • Public Health, Other  • Diagnosis  • Screening  • Infectious Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Progress and Challenges

John G. Bartlett, MD; Bernard M. Branson, MD; Kevin Fenton, MD, PhD; Benjamin C. Hauschild, MPH; Veronica Miller, PhD; Kenneth H. Mayer, MD

JAMA. 2008;300(8):945-951.

The Centers for Disease Control and Prevention (CDC) has recommended human immunodeficiency virus (HIV) testing for all persons aged 13 to 64 years in all health care settings. Signed consent would not be required and counseling with referral would be managed as it is for other serious conditions. The goal of the recommendations is to promote earlier entry into care to reduce unnecessary mortality and facilitate prevention by behavioral changes that accompany knowledge of serostatus. Concerns about the change include laws in some states that mandate signed consent and counseling, a perception that counseling is an effective prevention strategy, variability in payment coverage for the test, concerns about the stigma and discrimination that may accompany the HIV diagnosis, and the possibility that other testing policies would be more effective. Eleven of 16 states have changed legislation to reduce barriers to testing, 35 of 74 national professional societies have endorsed the new recommendations, and multiple demonstration projects have shown feasibility. Metrics to evaluate the health outcomes of the CDC's recommendations for HIV testing have been defined, but the data necessary to determine the effects on early entry into care, the actual reduction in disease incidence, and the unanticipated consequences are not yet available.

Author Affiliations: Johns Hopkins University, School of Medicine, Baltimore, Maryland (Dr Bartlett); Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Branson and Fenton); Forum for Collaborative HIV Research and George Washington University, Washington, DC (Mr Hauschild and Dr Miller); and Department of Medicine, Brown University, and Miriam Hospital, Providence, Rhode Island (Dr Mayer).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

CDC Recommendations for Opt-Out HIV Testing
David R. Holtgrave
JAMA. 2009;301(3):274.
EXTRACT | FULL TEXT  

CDC Recommendations for Opt-Out HIV Testing
Lawrence Corey
JAMA. 2009;301(3):274-275.
EXTRACT | FULL TEXT  

CDC Recommendations for Opt-Out HIV Testing—Reply
John G. Bartlett and Kenneth Hugh Mayer
JAMA. 2009;301(3):275-276.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Implementation of and Barriers to Routine HIV Screening for Adolescents
Minniear et al.
Pediatrics 2009;124:1076-1084.
ABSTRACT | FULL TEXT  

Case 29-2009 -- An 81-Year-Old Man with Weight Loss, Odynophagia, and Failure to Thrive
Stone et al.
NEJM 2009;361:1189-1198.
FULL TEXT  

Consistency of State Statutes With the Centers for Disease Control and Prevention HIV Testing Recommendations for Health Care Settings
Mahajan et al.
ANN INTERN MED 2009;150:263-269.
ABSTRACT | FULL TEXT  

CDC Recommendations for Opt-Out HIV Testing
Holtgrave
JAMA 2009;301:274-274.
FULL TEXT  

CDC Recommendations for Opt-Out HIV Testing
Corey
JAMA 2009;301:274-275.
FULL TEXT  

Screening for HIV in Health Care Settings: A Guidance Statement From the American College of Physicians and HIV Medicine Association
Qaseem et al.
ANN INTERN MED 2009;150:125-131.
ABSTRACT | FULL TEXT  

Evolution of State Laws Related to HIV Testing
AIDS Clin Care 2008;2008:3-3.
FULL TEXT