Review the Scientific Evidence for HIV Screening

In the September 2006 issue of Morbidity and Mortality Weekly Report, CDC released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in HealthCare Settings. The revised recommendations are intended for all healthcare providers in public or private practice where other diagnostic and screening tests are performed routinely.

Major revisions from previously published guidelines include:

• HIV screening is recommended for all patients aged 13 to 64 years in all healthcare settings after the patient is notified that testing will be done 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 is not recommended; general consent for medical care should be sufficient to encompass consent for HIV testing.
• Prevention counseling should not be required with HIV diagnostic testing or as part of routine HIV screening programs in healthcare settings.
• 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 done, unless the patient declines (opt-out screening).

In 2009, Screening for HIV in Health Care Settings: A Guidance Statement from the American College of Physicians and HIV Medicine Association was published in the Annals of Internal Medicine. The guidance statement aligns with CDC’s Revised Recommendations for HIV Screening.

• Guidance Statement 1: ACP recommends that clinicians adopt routine screening for HIV and encourage patients to be tested.
• Guidance Statement 2: ACP recommends that clinicians determine the need for repeat screening on an individual basis.

The AAFP recommends that clinicians screen adolescents and adults ages 18 to 65 years for HIV infection. Younger adolescents and older adults who are at increased risk should also be screened. See the Clinical Considerations for more information about screening intervals (2013)