Kaiser Daily HIV/AIDS Report Summarizes Editorials, Opinion Pieces on CDC Routine HIV Testing Recommendations

Several newspapers recently published editorials and opinion pieces regarding the new CDC HIV testing recommendations. CDC last week released revised recommendations on HIV testing in the U.S. that say HIV tests should become a routine part of medical care for residents ages 13 to 64 and that requirements for written consent and pretest counseling be dropped. CDC estimates that about 25% of HIV-positive people in the U.S. do not know their status. Many physicians believe that routine testing could lead to an earlier diagnosis and earlier treatment. According to an agency release, the recommendations, published in the Sept. 22 edition of CDC's Morbidity and Mortality Weekly Report, were designed to "simplify the HIV testing process" and "overcome several barriers that hindered implementation" of the agency's previous guidelines -- released in 1993 -- calling for tests to be given to "high-risk individuals" and to all patients "in health care settings" with HIV prevalence of more than 1%. According to the revised guidelines, health care providers should continue routine HIV testing unless they establish that less than one of every 1,000 patients tested is HIV-positive, at which point such screening is no longer warranted (Kaiser Daily HIV/AIDS Report, 9/22). Summaries appear below.

Editorials

• Akron Beacon Journal: Although CDC's HIV testing recommendations are a "necessary step forward" in the fight against HIV/AIDS, they nonetheless "pos[e] challenges," including the cost of follow-up testing and treatment for people who are found to be HIV-positive and "appropriate counseling to help patients cope with health care decisions after a diagnosis," a Beacon Journal editorial says, adding that despite these challenges, a "greatly expanded testing program" is a "crucial part of a broad approach to halt the spread of a vicious virus" (Akron Beacon Journal, 9/27).
  

• Baltimore Sun: "Widespread routine HIV/AIDS testing may well help reduce the stubbornly static infection rate and even the stigma," a Sun editorial says, adding, "But given the finite limits of health care resources, so broad an approach makes little sense" (Baltimore Sun, 9/27).
  

• Cincinnati Enquirer: CDC's revised recommendations could "knock down the 40,000 HIV cases added" annually and "would wise up more of the estimated 250,000 Americans who are unaware they are infected," an Enquirer editorial says, adding that "we first need to understand all the foreseeable consequences, not least of which is the cost of expanded tests and treatment" (Cincinnati Enquirer, 9/23).
  

• Des Moines Register: Routine HIV testing is a "smart move" because it will allow individuals to take advantage of antiretroviral drugs "that translate into longer, healthier lives"; encourage them to "protect their sexual partners and unborn children"; and "remove any stigma associated with testing," a Register editorial says, adding "Identifying people who are HIV-positive is a good step -- but only if those who test positive have access to needed drug therapies and counseling" (Des Moines Register, 9/27).
  

• Greensboro News & Record: "The benefits of knowing" one's HIV status "definitely outweigh the hazards of not knowing," because "[u]nlike the early days of the AIDS epidemic ... there's no longer reason to treat HIV tests differently from those for other communicable diseases," a News & Record editorial says (Greensboro News & Record, 9/26).
  

• Lexington Herald-Leader: "Diagnosing HIV infection earlier will boost costs for medical care in the short run," a Herald-Leader editorial says, adding, "but tracking the extent of the epidemic and preventing future infections is well worth it" (Lexington Herald-Leader, 9/28).
  

• Long Island Newsday: "[A]ll states ... would be wise to embrace" the new CDC recommendations but should continue to "offer counseling to patients who test positive -- not only to help them cope with the powerful emotional blow of such news, but to suggest a course of care," a Long Island Newsday editorial says (Long Island Newsday, 9/27).
  

• Oregonian: CDC's recommendations are "right" because the "practical way to counteract the unknowing spread of the virus is more testing and more knowing," an Oregonian editorial says (Oregonian, 9/25).
  

• Portland Press-Herald: Although the "stigma of being HIV-positive will likely continue to deter many from being tested," efforts from public health officials to "overcome this obstacle" will be "worth it," a Press-Herald editorial says. "Any effort that helps prevent the spread of AIDS and provides for early treatment is a good thing," the editorial concludes (Portland Press-Herald, 9/25).
  

• San Jose Mercury News: CDC's recommendations might lead to an increase in earlier HIV diagnoses that "will boost costs for medical care in the short run but tracking the extent of the epidemic and preventing future infections is well worth it," a Mercury News editorial says (San Jose Mercury News, 9/25).
  

Opinion Pieces

• Mike King, Atlanta Journal-Constitution: CDC's proposal "represents a seismic shift from the early days of the [HIV/AIDS] epidemic," King, a columnist for the Journal-Constitution, writes in an opinion piece, adding, "[i]f AIDS testing becomes a routine part of a medical screening ... the nation will get closer to three goals: no more HIV-infected children, no one with it going for years without treatment and eventually no more new cases of the disease" (King, Atlanta Journal-Constitution, 9/25).
  

• Tamara Lange, San Jose Mercury News: CDC's recommendations "eliminate the safeguards that ensure testing is voluntary and informed" and "raise serious privacy concerns," Lange, an attorney with the American Civil Liberties Union of Northern California, writes in a Mercury News opinion piece. "Written consent and counseling need not be barriers to testing," Lange writes, adding, "People will be better able to take care of themselves and one another if medical providers routinely offer testing and explain its benefits" (Lange, San Jose Mercury News, 9/28).
  

• Kenneth Mayer, Atlanta Journal-Constitution: "In 2006, there's good reason for all American adults to know their HIV status and to get tested regularly," Mayer -- professor of medicine and community health at Brown University and medical research director of the Fenway Community Health center -- writes in a Journal-Constitution opinion piece. He concludes, "Stopping the epidemic will require nothing less" (Mayer, Atlanta Journal-Constitution, 9/22).