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HIV Screening as Standard Care •

About 20% of Americans living with HIV are unaware they are infected. To address this fact, the CDC recommends routine voluntary HIV screening as a normal part of medical care, similar to screening for other treatable conditions. To reduces HIV transmission and improve medical outcomes the CDC recommends:

clinicians adopt routine screening for HIV and encourage patients to be tested.
HIV screening for all patients ages 13-64 in all health care 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 health care settings.
HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women, and HIV screening is recommended after the patient is notified that testing will be done unless the patient declines (opt-out screening).

Currently 48 states have complied with CDC’s HIV screening recommendations.• New York State and North Dakota are the two states that remain non-compliant with CDC HIV testing recommendations. These two states have chosen an Opt-In testing model which requires specific consent before testing can occur. HIV Opt-In testing models impose a significant barrier to care that does not exist for other routine laboratory tests. For example, a separate consent is not required for every component of a routine Complete Blood Count (CBC) or Chemistry panel. Effective medical care and prevention of transmission cannot occur in an environment of intentional ignorance.

Another barrier to HIV screening has been the cost of testing. The Affordable Care Act has lowered the cost barrier for the majority of Americans. Many health insurance plans are now covering routine HIV testing. After April, 30 2014, all plans are required to cover routine HIV screening.