State urges routine testing for HIV

Clearing the way for HIV testing to become almost as routine as checking for cholesterol, state public health officials issued an advisory today saying that the written consent required by law can be included in general permission forms patients sign for medical care.

The new advice, issued by the state Department of Public Health, recommends testing adolescents and adults from 13 to 64 years old in all heathcare settings, no matter what brings them to the hospital or doctor's office. People who fall into high-risk categories should be screened annually for HIV, the virus that causes AIDS.

The new directive brings Massachusetts closer to federal guidelines promoted by the US Centers for Disease Control and Prevention in 2006 as a way to reduce the spread of HIV. People who do not know they are infected -- estimated to be about a quarter of cases -- account for the majority of new HIV transmission, Kevin Cranston, director of the state's Bureau of Infectious Diseases, told the state's Public Health Council today.

Currently, separate permission forms that require consent for HIV testing pose a barrier for patients and healthcare providers alike, officials said. Along with a handful of other states, Massachusetts had balked at treating HIV testing like other tests, citing the stigma that still clings to the disease. State law mandates written consent for HIV testing and counseling for patients. Today's policy says talking with patients about information provided by the state public health department will be considered adequate prevention counseling and should be a part of HIV screening.

Streamlining the testing process should bring people to treatment earlier when it can prevent progression to AIDS, Dr. Lauren Smith, DPH medical director, said.

"The take-home message is 31 percent of folks diagnosed with HIV progress to AIDS within two months," she said, citing Massachusetts figures from 2005 through 2007. "If this happened a decade ago, we might have tolerated that. Now that we have very effective treatments, that is inappropriate. I'm hoping that statistic alone will be enough to really prompt substantial change in my fellow clinicians."