More Than 30 States Have Laws Hindering Physicians From Implementing Routine HIV Testing, Study Says

More than 30 states have laws that hamper doctors from implementing CDC's 2006 recommendations for routine HIV testing, according to a study published online Tuesday in PLoS One, the AP/Google.com reports (Stobbe, AP/Google.com, 10/9). CDC in September 2006 released revised recommendations on HIV testing in the U.S. The recommendations advise that HIV tests become a routine part of medical care for residents ages 13 to 64 and that requirements for written consent and pretest counseling be dropped (Kaiser Daily HIV/AIDS Report, 6/13).

For the study, Leslie Wolf, an associate professor of law at Georgia State University, and colleagues used legal databases to search state laws and look for recent amendments to determine the extent of state legal barriers to routine testing. Their results were current through July but did not include proposed legislation, the AP/Google.com reports. The researchers found that 33 states require informed consent for HIV tests and that 24 states require disclosure of information about testing and the virus during pretest counseling or the consent process. According to Wolf, both requirements are barriers to CDC's guidelines as currently written. Only Rhode Island and Illinois have taken actions attempting to comply with the agency's recommendations; however, both states left some form of informed consent or pretest counseling provisions, Wolf said.

Lawrence Gostin -- a public health law expert at Georgetown University who was not involved with the study -- said, "I think if [the states] were going to change, they would have done so by now," adding that it is unlikely there will be much additional legislation. "The political impetus was then, and they're on to other things," Gostin said of state lawmakers. Some CDC officials disagreed and cited more than six states that have made some kind of law change to simplify HIV testing. They added that additional changes appear to be imminent in California and other states. "I don't think it's a done deal," Bernard Branson, associate director for laboratory diagnostics in CDC's Division of HIV/AIDS Prevention, said, adding, "It depends how you classify 'barriers.' I can't comment specifically on this study and how they came to their conclusions." According to Branson, Illinois, Indiana, Iowa, Maine, New Hampshire and New Mexico recently have changed their informed consent laws to better conform to CDC's recommendations. There is no national data yet to indicate the implications the guidelines have had, Branson said (AP/Google.com, 10/9).

The study is available online.