Increasing Access to Voluntary HIV Testing
Revised CDC Recommendations for HIV Testing, Informed Consent and Pre-Test Counseling
In September 2006, the Centers for Disease Control and Prevention (CDC) issued new recommendations for expanded HIV testing (available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm). The CDC now recommends that medical providers offer all persons ages 13 to 64 voluntary HIV testing without risk assessments as a routine part of medical care. We agree that increasing access to testing and care is a critically important goal. Far too many people do not know their HIV status, and we support efforts to help people living with undiagnosed HIV learn their status and gain access to necessary care and support services. However, we believe that eliminating specific consent and pretest counseling, as the CDC recommends, would remove safeguards guaranteeing that testing stays voluntary and informed.
The CDC’s recommendations have been the topic of much discussion, on the part of health care providers, public officials, media, and advocates. Some of that discussion overstates the extent to which the CDC is recommending elimination of pre-test consent and pre-test counseling, the extent to which the recommendations differ from existing state laws, and the legal effect of the recommendations. Here we attempt to clear up that confusion, so that decisions about implementing the recommendations will not be influenced by inaccurate assumptions about their content.