Jumpstarting HIV Testing

Saying AIDS prevention efforts have "stalled," the government announced a new strategy Thursday it hopes will sharply increase routine testing of people at risk for the disease.

The CDC also said it was recommending routine HIV tests for all pregnant women and any infants of women who refused to be tested. About 300 babies each year become infected with HIV, the virus that causes AIDS, from their mothers.

Officials want doctors to be able to give a new rapid HIV test — which provides results in just 20 minutes — without a required counseling session. Tests would also be given in homeless shelters, drug treatment centers, jails and other non-medical settings.

"We want to eliminate access to the medical system as a barrier to testing," said Dr. Julie Gerberding, director of the federal Centers for Disease Control and Prevention.

Each year, about 40,000 new HIV cases are diagnosed in the United States. More than 800,000 people live with HIV, and a quarter of those people don't know they have been infected.

"We've made enormous progress in that global epidemic, but our prevention efforts have stalled," Gerberding said. "We have not made the new kinds of progress that we would expect to achieve given new advances in technology."

An advocacy group questioned the new strategy, saying the CDC needs to make sure that counseling for those tested is not lost.

"We're seeing a shift away from a specific HIV prevention strategy to a kind of medical model of HIV prevention," said David Harvey of the AIDS Alliance for Children, Youth and Families in Washington. "And we don't think that's a good move."

CDC officials also want to find better ways to notify and counsel partners of those who have been infected. Gerberding said efforts until now have been focused largely on addressing behaviors in uninfected people.

"We haven't put as much emphasis on HIV-infected people as we should," she said. "It's very important to know who their partners are and to make sure they have access to prevention treatment."

As for pregnant women, Gerberding said each case of mother-to-infant infection "represents a failure in the public health system."

"Mothers can decide to not have the test but, if they choose not to have the test, we want to make sure their children are tested after birth so they can benefit from lifesaving treatment," she said.

But Harvey said the current plan has helped reduce the rate of newborns with HIV from about 1,000 a year in 1992. He said providing prenatal care for women is more valuable than routine testing of pregnant women.

About $35 million from Congress will fund demonstration projects to determine the best way to implement the new plan, which will be evaluated with an additional $5 million in funding, Gerberding said.