Routine HIV testing may violate many state laws

A new study concludes that routine testing for HIV recommended by the Centers for Disease Control (CDC) may violate many state laws.

The study, published on October 10 in the online, open-access journal PLoS ONE), found that more than thirty states require specific consent before HIV testing may occur. Nearly half of them require that consent to be in writing.

Those state laws stand in contrast to recommendations issued by the CDC in 2006, recommending routine HIV testing for all Americans between ages 13 and 64. According to the CDC, adults should be tested, after notification, unless they refuse. Organizations around the country are now considering how to implement the CDC's recommendations.

Researchers, led by Leslie Wolf at Georgia State University College of Law's Center for Health, Law and Society, learned that almost half the states require disclosure of specific information about HIV to patients before testing. Required disclosures include information describing how HIV is transmitted, what people can do to protect themselves from getting the disease, and what will be done with test results. These requirements were adopted to encourage testing when the HIV test first became available in the 1980s. Professor Wolf and her colleagues found that states that have recently amended their HIV laws have kept these requirements, despite the CDC recommendations.

Wolf and her colleagues contend that HIV testing practices are unlikely to change without better understanding of why states have retained requirements for specific consent and pre-test counseling. They suggest that under the limited disclosures contemplated by the CDC, patients may not have enough information to make an informed decision about HIV testing. In addition, eliminating requirements for pretest disclosures and counseling may remove an important mechanism for educating individuals about HIV and reducing risk of disease transmission.