The federal government recommended today that hospitals in areas with significant numbers of HIV/AIDS cases routinely offer HIV testing to most patients.
Testing would be voluntary but would be offered to all people aged 15 to 54, admitted as patients or treated as outpatients in these hospitals. Under the guidelines, all results would be confidential and people who refused testing would still be given full medical care.
The Recommendations for HIV Testing Services for Inpatients and Outpatients in Acute-Care Hospital Settings were made available by the Centers for Disease Control and Prevention in Atlanta, a U.S. Public Health Service agency, based on new data that would indicate that many unrecognized HIV infections would be revealed by such hospital-based testing.
HHS Secretary Donna E. Shalala said, "These recommendations will help people learn of their HIV status and get early treatment to delay the disease and prolong their lives. Knowing their status, they will also be able to take precautions to protect loved ones."
CDC studies indicate HIV infection rates as high as 8.9 percent among persons receiving care in some emergency rooms and as high as 7.8 percent among hospitalized people. (In the hospitals surveyed, rates were as low as 0.2 percent and 0.3 percent, respectively.) CDC's surveys used anonymous blood samples. Hospitals could learn their own rate by similar anonymous testing. Other studies indicate as many as 65% of HIV positive patients were not aware of their HIV status.
The new recommendations call for hospitals to "strongly consider" offering HIV counseling and testing routinely to patients aged 15-54 years if the prevalence rate is higher than 1 percent, or one in a thousand discharged patients have AIDS. Patients in this age range at these hospitals account for about 68 percent of HIV infected persons hospitalized in the United States for conditions other than HIV/AIDS.
CDC recommends all acute-care facilities encourage health-care providers to routinely ask patients about their risks for HIV infection and offer HIV counseling and voluntary testing services to patients at risk. CDC also encourages other health care institutions such as drug treatment centers and private medical practitioners to consider offering these services.
The counseling and testing procedures should be structured to:
- acilitate confidential, voluntary patient participation include pretest information on the testing policies of the institution or physician
- provide basic information about the medical implications of the test
- give patients the option to receive more information
- document informed consent of the patient
CDC also released Technical Guidance on HIV Counseling, which supplements Public Health Service Guidelines for Counseling and Antibody Testing to Prevent HIV Infection and AIDS published in August 1987.