Routine testing for HIV urged by health officials

ATLANTA — Federal health officials on Thursday recommended regular, routine testing for the AIDS virus for all Americans ages 13 to 64, saying an HIV test should be as common as a cholesterol check.

The U.S. Centers for Disease Control and Prevention guidelines are aimed at preventing the further spread of the disease and getting needed care for an estimated 250,000 Americans who don't yet know they have it.

"We simply must improve early diagnosis," said CDC Director Dr. Julie Gerberding.

Nearly half of new HIV infections are discovered when doctors are trying to diagnose a patient who has already grown sick with an HIV-related illness, CDC officials said.

"By identifying people earlier through a screening program, we'll allow them to access life-extending therapy, and also, through prevention services, learn how to avoid transmitting HIV infection to others," said Dr. Timothy Mastro, acting director of the CDC's division of HIV/AIDS prevention.

Although some groups raised concerns, the announcement was mostly embraced by health policy experts, doctors and patient advocates.

"I think it's an incredible advance. I think it's courageous on the part of the CDC," said A. David Paltiel, a health policy expert at the Yale University School of Medicine.

The recommendations aren't legally binding, but they influence what doctors do and what health insurance programs cover. The recommendations were endorsed by the American Medical Association, which urged doctors to comply.

Previously, the CDC recommended routine testing for those at high risk for catching the virus, such as intravenous drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommended testing for all pregnant women.

Under the new guidelines, patients would be tested for the AIDS virus as part of the standard tests they get when they go for urgent or emergency care, or even during a routine physical.

The CDC recommends everyone get tested at least once, but annual testing is urged only for people at high risk.

Consent for the test would be covered in a clinic or hospital's standard care consent form. Patients would be allowed to decline the testing. The CDC's guidelines say no one should be tested without their knowledge.

An American Civil Liberties Union official protested the CDC's idea of dealing with HIV on standard consent forms, and the agency's de-emphasis of pre-test counseling.