GUIDELINES & RECOMMENDATIONS

Centers for Disease Control and Prevention, Revised HIV Testing Recommendations

In the September 2006 issue of Morbidity and Mortality Weekly Report, CDC released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in HealthCare Settings. The revised recommendations are intended for all healthcare providers in public or private practice where other diagnostic and screening tests are performed routinely.

Major revisions from previously published guidelines include:

  • HIV screening is recommended for all patients aged 13 to 64 years in all healthcare settings after the patient is notified that testing will be done unless the patient declines (opt-out screening).
  • Persons at high risk for HIV infection should be screened for HIV at least annually.
  • Separate written consent for HIV testing is not recommended; general consent for medical care should be sufficient to encompass consent for HIV testing.
  • Prevention counseling should not be required with HIV diagnostic testing or as part of routine HIV screening programs in healthcare settings.
  • HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women. HIV screening is recommended after the patient is notified that testing will be done, unless the patient declines (opt-out screening).

 

CDC HIV Pre-Exposure Prophylaxis Guidelines

In 2014, the CDC and the U.S. Public Health Service released new clinical guidelines recommending health care providers consider prescribing pre-exposure prophylaxis (PrEP) for patients at substantial risk for HIV infection. PrEP is the strategy of providing daily oral antiretroviral drugs continuously to uninfected individuals prior to HIV exposure. It has been shown to reduce HIV acquisition among all populations at high risk. These new guidelines replace the interim guidance and are the first to offer detailed and comprehensive clinical guidance on PrEP for both sex partners and drug injection partners. The new guidelines also include a providers’ supplement with additional materials and tools for clinicians who prescribe PrEP. These materials include a checklist for providers to use in discussions withpatients, fact sheets to help providers and patients increase their knowledge about PrEP, and a risk assessment tool.

The new guidelines and clinical providers’ supplement are published in full at http://www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf and http://www.cdc.gov/hiv/pdf//guidelines/ PrEPProviderSupplement2014.pdf.

To learn more about efforts to implement PrEP in the United States, visit www.cdc.gov/hiv/prevention/research/prep/

 

American College of Physicians (ACP) Clinical Guidelines

In 2009, Screening for HIV in Health Care Settings: A Guidance Statement from the American College of Physicians and HIV Medicine Association was published in the Annals of Internal Medicine. The guidance statement aligns with CDC’s Revised Recommendations for HIV Screening.

  • Guidance Statement 1: ACP recommends that clinicians adopt routine screening for HIV and encourage patients to be tested.
  • Guidance Statement 2: ACP recommends that clinicians determine the need for repeat screening on an individual basis.

 

U.S. Preventive Services Task Force Recommendations

In 2013, the U.S. Preventive Services Task Force (USPSTF) issued a final recommendation statement on screening for HIV.

  • Everyone aged 15 to 65 years should be screened for HIV infection. Teens younger than 15 and adults older than 65 also should be screened if they are at increased risk for HIV infection.
  • All pregnant women, including women in labor who do not know their HIV status, should be screened for HIV infection.

Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations

HIV Infection: Detection, Counseling, and Referral, 2015 Sexually Transmitted Diseases Treatment Guidelines

Updated Guidelines for Antiretroviral Postexposure Prophylaxis After Sexual, Injection Drug Use, or Other Nonoccupational Exposure to HIV—United States, 2016