Intended for healthcare professionals


CDC to call for routine AIDS testing for people aged 13-64

BMJ 2006; 332 doi: (Published 18 May 2006) Cite this as: BMJ 2006;332:1169
  1. Janice Hopkins Tanne
  1. New York

    Adolescents, adults, and pregnant women in the United States should be routinely tested for HIV, the virus that causes AIDS, said experts from the US Centers for Disease Control and Prevention (CDC) at a news conference last week that marked the 25th anniversary of the AIDS epidemic.

    When finalized, the CDC's recommendations will be published in the next two months in the centre's Morbidity and Mortality Weekly Report (

    HIV testing should become as routine as measuring blood pressure and cholesterol, CDC officials said. New, quicker tests for HIV make testing easier in a doctor's office, clinic, or emergency room.

    The CDC will recommend that people aged 13-64 have at least one HIV test. People at high risk should be tested annually. The proposed revisions to the previous 1993 guidelines say, “HIV screening is recommended in all health care settings, after notifying the patient that testing will be done unless the patient declines… Separate written consent for HIV testing is not required. General consent for medical care is sufficient to encompass consent for HIV testing. Prevention counselling need not be conducted in conjunction with HIV testing… [and] is not recommended as part of routine HIV screening in health care settings.”

    For pregnant women, “HIV screening should be included in the routine panel of prenatal screening tests… [and] is recommended after notifying the patient that testing will be done unless the patient declines… Repeat screening in the third trimester is recommended in certain jurisdictions with high rates of HIV infection among pregnant women.”

    By making testing routine, CDC hopes to lessen the stigma attached to HIV and to detect people who do not know they are infected. More than a million Americans are thought to be infected, but an estimated 250 000 of them do not know it.

    People who do not know they are infected can spread the infection for years before they develop signs of AIDS. If they are identified early by routine testing they can be counselled on safe sex behaviour, their health can be monitored, early treatment provided, and perinatal transmission reduced. Unprotected anal or vaginal intercourse with uninfected partners is 68% lower when people know they are infected, the proposed guidelines say.

    At present, people who seek an HIV test often do so because they think they may have been exposed to the virus. Until now, testing for HIV has been treated differently from testing for other potentially life threatening diseases, partly because the first HIV cases occurred in groups already at risk for discrimination.


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