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Recommendations for HIV Testing Services for Inpatients and Outpatients in Acute-Care Hospital Settings

CDC has published revised recommendations for human immunodeficiency virus (HIV) counseling and testing of patients in acute-care hospital settings (1).* These recommendations update previous CDC guidelines published in 1987 (2) and strengthen the recommendation for hospitals to assess the rate of HIV infection among their patient populations and to develop HIV-testing programs that assist infected patients in obtaining HIV-related treatment and prevention services. The revision was prompted by information regarding both the rates of previously unrecognized HIV infection among persons admitted to some acute-care hospitals and the potential medical and public health benefits of recognizing HIV infection in persons who have not developed acquired immunodeficiency syndrome (AIDS).

CDC recommends that hospitals and associated clinics encourage health-care providers to routinely ask patients in nonemergency settings about their risks for HIV infection. Patients at risk should be offered HIV counseling and testing services with informed consent obtained in accordance with local laws. In addition, hospitals with an HIV-seroprevalence rate of at least 1% or an AIDS diagnosis rate greater than or equal to 1.0 per 1000 discharges (3) should strongly consider adopting a policy of offering such services routinely to patients aged 15-54 years. These services should be structured to facilitate confidential, voluntary patient participation and should include pretest information about the testing procedures, appropriate posttest counseling for infected patients and those at increased risk, and referral of HIV-infected persons for medical evaluation. Persons who decline HIV testing or who consent to testing and are found to be infected must not be denied needed health care or provided suboptimal care.

The recommendations emphasize that HIV counseling and testing programs should not be used as a substitute for universal precautions or other infection-control techniques and underscore the importance of effective and ongoing collaboration between acute-care providers and health departments to improve HIV-related prevention and treatment services.

References

  1. CDC. Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings and technical guidance on HIV counseling. In: Recommendations and reports (January 15). MMWR 1993;42(no. RR-2):1-6.

  2. CDC. Public Health Service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. MMWR 1987;36:509-15.

  3. Janssen RS, St. Louis ME, Satten G, et al. HIV infection among patients in U.S. acute-care hospitals: strategies for the counseling and testing of hospital patients. N Engl J Med 1992;327:445-52.

    • Single copies of the recommendations will be available from the CDC National AIDS Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003; telephone (800) 458-5231.

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**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

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