HIV tests yet to be routine in hospitals

WASHINGTON — Two years after the government urged making HIV tests as common as cholesterol checks, there are small gains but still one in five people infected with the AIDS virus doesn't know it, scientists said Thursday.

States that once required special consent for HIV testing have changed their laws, a key step to making an HIV test part of the standard battery that patients expect.

But HIV specialists meeting Thursday said other barriers include physician confusion about the ease of today's rapid tests, which can cost as little as $15, although many patients seem to accept them.

No more than 100 of the nation's 5,000 emergency rooms routinely test for HIV in patients who aren't critically ill, said Dr. John Bartlett of Johns Hopkins University, who co-chaired the Forum for Collaborative HIV Research meeting. Yet because so many HIV patients are poor or uninsured, ERs are the health-care setting most likely to find them.

And while every pregnant woman is supposed to be tested so steps can be taken to protect her fetus, about 40 percent aren't, he added.

"Those are what we call missed opportunities," Bartlett said. Today, the test is "much better, it's much easier, it's much cheaper. The treatment is really great now."

About 1.1 million Americans are estimated to have HIV, the virus that causes AIDS, and 232,000 don't know it, according to the Centers for Disease Control and Prevention (CDC).

The CDC for years recommended routine testing mainly for people at high risk, such as intravenous drug users. Then came drugs potent enough to keep HIV patients healthy for years, postponing the slide into full-blown AIDS. Yet nearly half of new infections still were being discovered too late. People who don't know they're infected also unwittingly spread the virus.

So the CDC in September 2006 recommended routine testing for everyone 13 to 64. There is no nationwide data on the new guidelines' impact.

Studies presented Thursday suggest more than 80 percent of emergency-room patients were amenable to an HIV test while most ER workers opposed testing them. Why? Presumably because ERs are so busy and there's confusion about how much HIV counseling is needed.