CDC Backs HIV Test for All Between 13-64

[Mayberry]

CDC Backs HIV Test for All Between 13-64


Sep 21, 9:20 PM (ET)

By MIKE STOBBE
ATLANTA (AP) - Federal health officials Thursday recommended regular, routine testing for the AIDS virus for all Americans ages 13 to 64, saying an HIV test should be as common as a cholesterol check.

The U.S. Centers for Disease Control and Prevention guidelines are aimed at preventing the further spread of the disease and getting needed care for an estimated 250,000 Americans who don't yet know they have it.

"We simply must improve early diagnosis," said CDC Director Dr. Julie Gerberding.

Nearly half of new HIV infections are discovered when doctors are trying to diagnose a patient who has already grown sick with an HIV-related illness, CDC officials said.


"By identifying people earlier through a screening program, we'll allow them to access life-extending therapy, and also through prevention services, learn how to avoid transmitting HIV infection to others," said Dr. Timothy Mastro, acting director of the CDC's division of HIV/AIDS prevention.

Although some groups raised concerns, the announcement was mostly embraced by health policy experts, doctors and patient advocates.

"I think it's an incredible advance. I think it's courageous on the part of the CDC," said A. David Paltiel, a health policy expert at the Yale University School of Medicine.

The recommendations aren't legally binding, but they influence what doctors do and what health insurance programs cover.

However, some doctors' groups predict the recommendations will be challenging to implement, requiring more money and time for testing, counseling and revising consent procedures.

Some physicians also question whether there is enough evidence to expand testing beyond high-risk groups, said Dr. Larry Fields, the president of the American Academy of Family Physicians.

"Are doctors going to do it? Probably not," Fields said.

But the recommendations were endorsed by the American Medical Association, which urged doctors to comply. The CDC said it's difficult to predict how many doctors will.

Previously, the CDC recommended routine testing for those at high-risk for catching the virus, such as intravenous drug users and gay men, and for hospitals and certain other institutions serving areas where HIV is common. It also recommended testing for all pregnant women.

Under the new guidelines, patients would be tested for the AIDS virus as part of the standard tests they get when they go for urgent or emergency care, or even during a routine physical.

The CDC recommends everyone get tested at least once, but annual testing is urged only for people at high risk.

Consent for the test would be covered in a clinic or hospital's standard care consent form. Patients would be allowed to decline the testing. The CDC's guidelines say no one should be tested without their knowledge.

An American Civil Liberties Union official protested the CDC's idea of dealing with HIV on standard consent forms, and the agency's de-emphasis of pre-test counseling.

"By eliminating these safeguards, what they're calling 'routine testing' will in practice be mandatory testing," said Rose Saxe, a staff attorney with the ACLU AIDS Project.

The cost of the new policy is not clear. A standard HIV test can cost between $2.50 and $8, public health experts say.

New rapid tests cost about $15. If an initial result is positive, confirmatory tests can cost another $50 or more. Treatment for HIV can cost more than $10,000 a year.

WellPoint, the Indianapolis company that owns 14 Blue Cross and Blue Shield plans across the country, has not yet taken a position on the CDC guidelines.

It also hasn't estimated what it will cost to expand HIV testing for its 34 million members, but it traditionally covers tests recommended by the CDC, said WellPoint spokeswoman Shannon Troughton.

The recommendation, if fully implemented, could mean testing for to 100 to 200 million Americans, said Ron Spair, chief financial officer of Pennsylvania-based OraSure Technologies, one of three companies that sell rapid-result HIV tests in the United States.

The other companies are MedMira Inc. and Trinity Biotech. Standard HIV tests are done through both public health labs and private and commercial labs.

"This certainly expands the rapid HIV testing market," Spair said.

Identifying more HIV patients will place an added burden on public health programs that pay for such care, some of which are facing potential cuts under a proposal before Congress. But more diagnoses may help win bolstered funding, said John Peebles, an assistant branch chief over HIV programs at the North Carolina Department of Health and Human Resources.

"If you don't know what you need, you can't make the argument for resources," Peebles said.

The CDC has been working on the guidelines for about three years, and got input from more than 100 groups, including doctors' associations and HIV patient support groups.

I suppose this will be at taxpayer's expense. I personally do not need one. I have lived a clean life, and have been married for 10 years. Never had a transfusion, and don't do drugs. So why the hell would I need an HIV test?

[Elrathin]

I don't mind if they ALLOW routine tests for people, but I do not think everyday people should be forced to.

There should also be a limit. For instance just because some horn dog that sleeps with different people on a regular bases wants a test every week, shouldn't be allowed to get free tests.

[Mayberry]

I do not think everyday people should be forced to.
It sounds to me from the article that is what they intend to do. But the recommendations were endorsed by the American Medical Association, which urged doctors to comply.

[Rider]

Gee whiz, Craig- you sound as boring as me, LOL!

[Elrathin]

I do not think everyday people should be forced to.
It sounds to me from the article that is what they intend to do. But the recommendations were endorsed by the American Medical Association, which urged doctors to comply.


I don't know, the impression I got was for doctors to comply financially to people coming in is how I read it.

If I am wrong and they intend to make it mandatory for everyday people, then hell no.

[Rider]

The most tragic part of the aids epidemic in the US is that it has never been handled the way any other deadly communicable disease would have been. This is inexcusable and has cost the lives of thousands of innocent victims. I say let's do whatever the epidemiologists think will best stop the spread of this scourge. They're the experts. There's been more than enough activists and politicians mixed up in this.

[lily]

I have to agree with you on this one Rider. Also, it's not like someone is going to get tested every 3 months or every year. For most it probably will be only once....... and at $2.00-$8.50, it's not going to break the insurance companies.

[Mayberry]

I say let's do whatever the epidemiologists think will best stop the spread of this scourge. OK then. Keep it in your pants, don't do drugs, don't handle bodily fluids from someone you don't know VERY well, and don't get a transfusion from a disreputable source (don't know how to fully avoid that one, but the blood supply in the US is pretty safe). There you have it, stick to these guidelines, and you'll never have to worry about HIV.

[Alonzo]

I suppose this will be at taxpayer's expense. I personally do not need one. I have lived a clean life, and have been married for 10 years. Never had a transfusion, and don't do drugs. So why the hell would I need an HIV test?

So neither you or your wife has ever had another sexual partner or done drugs, and you can be absolutely certain that that is the case?

For all I know your wife spends her lunch breaks having sex with someone else. And if its not your wife, there are always some unsuspecting men and women where that's the case.

[Mayberry]

So neither you or your wife has ever had another sexual partner or done drugs, and you can be absolutely certain that that is the case?
Absolutely certain. there are always some unsuspecting men and women where that's the case. Of course. If you have the slightest doubt, go ahead and get tested.

[Alonzo]

But quite often people do not have any doubt. They either may not have reason to doubt, or may be in denial.

I'm not trying to say you should be suspicious. We all know that one of the best ways to screw up a relationship is to start thinking your partner may be cheating on you. But, humans as a whole, we also know that this happens, and that the partner may not suspect anything at all. The same can be said for drug use.

[Elrathin]

I say let's do whatever the epidemiologists think will best stop the spread of this scourge.


And what criteria do you use to force people to get tested?

[Elrathin]

I have to agree with you on this one Rider. Also, it's not like someone is going to get tested every 3 months or every year. For most it probably will be only once....... and at $2.00-$8.50, it's not going to break the insurance companies.


Sorry Lily, but IMO this is opening pandora's box. Do we as nation take away freedoms of individuals and force them to be tested whenever we want? What criteria do we use, how do we do it, and how often.

LIke I said ealier I have no problem with making the tests free to individuals that want it, but I don't want to see this turn into a witch hunt either.

[Mayberry]

Elrathin, I have to agree with you on this one, sort of. It is a Pandora's box, and a move in the direction of socialized medicine. Next you'll be forced to be screened for all sorts of ailments. Then what? you'll be REQUIRED to take certain medications? A perfect illustration was the recent court case of the young man with cancer, who the court tried to force to undergo chemo. Where does it end? Will we have any say so over our own bodies? Now as far as giving out "free" HIV tests, I don't think so. You want one, YOU pay for it. According to Lily, they're pretty cheap, so you'll have no problem paying for it yourself.

[Rider]

Elrathin wrote- lily Wrote:

I have to agree with you on this one Rider. Also, it's not like someone is going to get tested every 3 months or every year. For most it probably will be only once....... and at $2.00-$8.50, it's not going to break the insurance companies.



Sorry Lily, but IMO this is opening pandora's box. Do we as nation take away freedoms of individuals and force them to be tested whenever we want? What criteria do we use, how do we do it, and how often.

LIke I said ealier I have no problem with making the tests free to individuals that want it, but I don't want to see this turn into a witch hunt either.

Would you feel the same way about forcing people to be tested for Avian flu? How about quarantine? There's plenty of precedent for health authorities to require testing, quarantine, notification of sexual contacts, etc.. Pandora's box was opened a long time ago.

[Elrathin]

Would you feel the same way about forcing people to be tested for Avian flu? How about quarantine? There's plenty of precedent for health authorities to require testing, quarantine, notification of sexual contacts, etc.. Pandora's box was opened a long time ago.


The avian flu is airborne, meaning that ANYONE can get it no matter what. When AIDS is designated as an airborne virus, then I will support quarantines for it.

As it stands though, AIDS (Or rather HIV) is only transmitted through CERTAIN physical contact and only in CERTAIN ways.

[lily]

Sorry Lily, but IMO this is opening pandora's box.Â*Â*Do we as nation take away freedoms of individuals and force them to be tested whenever we want?Â*Â*What criteria do we use, how do we do it, and how often.

LIke I said ealier I have no problem with making the tests free to individuals that want it, but I don't want to see this turn into a witch hunt either.


I'm thinking of the greater good.

I can see your point on the pandora's box, I suppose. Next they will want DNA of every person.

[Elrathin]

I'm thinking of the greater good.

I can see your point on the pandora's box, I suppose. Next they will want DNA of every person.


The problem I see with using the "greater good" is where does it end and freedom take over? That line can easily be moved in the direction of the greater good without little effort is what I'm getting at. Given the government and how it is run, I don't trust it further than I can throw the statue of liberty with my own arms.

AIDS is a problem, however, as it stands right now the problem is contained through pyhsical contact, so IMO the best fight is still through education and sexual protection and not government mandated testing of everyday folks.

[lily]

Well, you change my mind. I do know, that I won't pass up the test if offered, no matter how long I've been married, never used IV drugs or had a transfusion.

Now, if I could only convince my doctor, that it is only manditory for doctors in California to harp on quitting smoking.......or so I've been told.

[Mayberry]

Next they will want DNA of every person. Ah, and there lies the problem. They will also advocate injecting everyone with a chip for "identification". They'll make it sound rosey with crap like "it'll help physicians in an emergency" but actually it will help the government keep track of you. I hate to sound like a conspiracy theorist, but there are people in government who think this way. Cars have a system built into the engine computer called OBD (onboard diagnostics). Currently we're at OBD II. California (yeah, really) proposed OBD III, which would include a satellite transceiver that would shut your car down on the spot if it was exceeding emissions limits. We can already see the level of control with Onstar, so this isn't beyond the realm of possibility by any means. Maybe they'll shut you down if you exceed the speed limit. Or if your registration is expired. Got a warrant? Car payment late? Inspection sticker expired? Exceeded you daily mileage limit (Don't think California hasn't thought of it)? Where does it end? It doesn't. Give an inch, loose a mile.

[Elrathin]

I do know, that I won't pass up the test if offered, no matter how long I've been married, never used IV drugs or had a transfusion.

Well I give blood regularly so my blood is tested anyways, but if offered I wouldn't have a problem with it. I just have a problem with someone notifying me that I HAVE to show up to be tested.


Now, if I could only convince my doctor, that it is only manditory for doctors in California to harp on quitting smoking.......or so I've been told.


Is it? I didn't know that doctors couldn't harp on folks to quite smoking. (If I read what you said correctly)

Me personally, I have asthma, and my doctor at the VA CONSTANTLY tells me to get rid of my cat. My response usually falls along the lines of "When hell freezes over" but he still tries :)

[Mayberry]

I have asthma, and my doctor at the VA CONSTANTLY tells me to get rid of my cat. And with socialized healthcare he can MAKE you get rid of the cat. Can't be wasting "the people's" money on allergy meds that you wouldn't need if it weren't for that cat. O.K., that's enough conspiracy for me:D It's made out of people....PEOPLE!!!

[Elrathin]

[quote]I have asthma, and my doctor at the VA CONSTANTLY tells me to get rid of my cat.


No he can't, because my asthma cannot be linked to my cat. Trust me I know this because he has told me. My tests show UNCONCLUSIVE that my cat is part of my allergies.

I live in Nevada and actually the majority of my problems comes from the Sage and not the cats. (And before you try to bring it up, no they cannot force you to move either).

[lily]

Elrathin



Well I give blood regularly so my blood is tested anyways, but if offeredÂ*Â*I wouldn't have a problem with it.Â*Â*I just have a problem with someone notifying me that I HAVE to show up to be tested.

Same here, but I took the article to mean that your doctor would be doing it anyway.



Is it?Â*Â*I didn't know that doctors couldn't harp on folks to quite smoking. (If I read what you said correctly)

I thought it was just a law in California.......guess I'm wrong again.

See, Elrathin.......I have to keep answering posts.....they changed the highest poster to highest poster of the day.......and you're the highest poster for the day! I was in 4th place when it was just highest poster.....;)

[Elrathin]

I thought it was just a law in California.......guess I'm wrong again.

Well you may be right on California, I don't know. I know in Nevada they are not restricted to get you to quit smoking cause my friend complains that his doctor contantly harrasses him about stopping smoking. But then so do I so I tell himn to quit his bitching :)


See, Elrathin.......I have to keep answering posts.....they changed the highest poster to highest poster of the day.......and you're the highest poster for the day! I was in 4th place when it was just highest poster.....;)

hehehe a lot of that may be just me being stubborn to some posters here I'll admit it.

Numbers don't mean much to me, just the content. And no I am not perfect on that even, but I do try to be most of the times. :)

[Rider]

Elrathin wrote- Rider Wrote:

Would you feel the same way about forcing people to be tested for Avian flu? How about quarantine? There's plenty of precedent for health authorities to require testing, quarantine, notification of sexual contacts, etc.. Pandora's box was opened a long time ago.



The avian flu is airborne, meaning that ANYONE can get it no matter what. When AIDS is designated as an airborne virus, then I will support quarantines for it.

As it stands though, AIDS (Or rather HIV) is only transmitted through CERTAIN physical contact and only in CERTAIN ways.
Geez El, would you start reading my posts? I never advocated quarantine for aids, nor was I making a comparison between aids and the avian flu. I was merely pointing out that disease control agencies have in the past been authorized to order compliance for the protection of the population as a whole.
In the past when anyone was treated for a venereal disease such as gonnorhea or syphlis the person was required to give the names and address of his or her sexual partners so the spread of the disease could be stopped. Do you disagree with this? If this had been required for persons infected with the aid virus thousands of lives could have been saved.

[Technocrat]

I would have to know what they would do with the results from the tests, who would view them, etc.

I wouldn't mind people having to get tested for various types of disease for their own protection and public health if it could be useful information; the question is--is it?

If it is, I guess it would be important to know what to do from there. It is a serious problem, and perhaps it woul be useful to catch it early, known who has it.

However, I wonder what the unwanted consequences of the measure would be; I would hope against some form of irrational discrimination if everyone had access to the information; perhaps it would have to be confidential.

If it isn't covered by insurance, it ought to be funded by the State as a public health measure (if someone cannot afford it) so as not to discourage people from getting tested.

It still wouldn't protect potential sexual partners though if there's no record or if the person doesn't have some form of record with him at all times.

[Mayberry]

If it isn't covered by insurance, it ought to be funded by the State as a public health measure (if someone cannot afford it) so as not to discourage people from getting tested Uh, no. I already have to pay for other people's health care when I don't even go to the doctor myself, unless they carry me in on a stretcher. People on medicaid, etc... go to the doctor when they have a sniffle, I know, I've been in the doctor's with my kids and seen them. And I've listened to some people my wife knows when they talk. And the three nurses I know tell us about it. I'm not going to pay for any more of anyone else's healthcare, sorry.

[Elrathin]

Geez El, would you start reading my posts? I never advocated quarantine for aids, nor was I making a comparison between aids and the avian flu.


First of all, show me where I said you are advocating it. You asked what I thought of it and I answered so why don't YOU take your own advice and start reading my posts.

Secondly, if you weren't comparing aids and the avian flu, why did you bring up the avian flu. This seems like a pattern with you. If you aren't making a comparison to something, they why bring it up in the way you did?

[Rider]

Elrathin wrote- Rider Wrote:

Geez El, would you start reading my posts? I never advocated quarantine for aids, nor was I making a comparison between aids and the avian flu.



First of all, show me where I said you are advocating it. You asked what I thought of it and I answered so why don't YOU take your own advice and start reading my posts.

The avian flu is airborne, meaning that ANYONE can get it no matter what. When AIDS is designated as an airborne virus, then I will support quarantines for it.
I took the last part of your statement as a rebuttal to the idea of quarantine. If that was not what you meant, I appologize.

Secondly, if you weren't comparing aids and the avian flu, why did you bring up the avian flu. This seems like a pattern with you. If you aren't making a comparison to something, they why bring it up in the way you did?

I was comparing the handling of the aids epidemic, which I had discussed earlier in this thread with the proposed handling of Avian Flu, should it break out in the human population, ie. politicized vs non-politicized.

[lily]

Technocrat

I would have to know what they would do with the results from the tests, who would view them, etc.

If I understand the article, it would be mandatory and your doctor would be the one doing it. I don't think any doctor can give out any information about you, unless you say so.

I was for this, but Elrathin changed my mind. If we allow this, what would be next? Mandatory DNA tests on file? My biggest fear with AIDS testing being madatory is somehow the insurance companies could get a hold of the information. It would only take one nurse needing some extra money for this to happen.

Uh, no. I already have to pay for other people's health care when I don't even go to the doctor myself, unless they carry me in on a stretcher. People on medicaid, etc... go to the doctor when they have a sniffle, I know, I've been in the doctor's with my kids and seen them. And I've listened to some people my wife knows when they talk. And the three nurses I know tell us about it. I'm not going to pay for any more of anyone else's healthcare, sorry.

According to the article the test would cost between $2.00 and $8.50. If that would prevent just one person from contrating this disease, think of how much money you would save in the long run.

[Technocrat]

If it isn't covered by insurance, it ought to be funded by the State as a public health measure (if someone cannot afford it) so as not to discourage people from getting tested Uh, no. I already have to pay for other people's health care when I don't even go to the doctor myself, unless they carry me in on a stretcher. People on medicaid, etc... go to the doctor when they have a sniffle, I know, I've been in the doctor's with my kids and seen them. And I've listened to some people my wife knows when they talk. And the three nurses I know tell us about it. I'm not going to pay for any more of anyone else's healthcare, sorry.


Oh boo hoo. *sniffle.* Don't care if you don't like paying for others. It's the right thing to do.

Yea, they go to the doctor when they have sniffles. When you provide some peer-reviewed medical or sociological studies that substantiate that claim, I will see fit to ignore it as merely anecdotal evidence. I needn't reiterate my stance on the value of personal experiential evidence. It's nigh worthless.

For every "experience" you say you have, I can make up 10 alternate ones.

Public healthcare ought to be increased, but reformed to more resemble the better systems of other countries. The reason you actually pay so much is due to an inherent inefficiency in OUR system. Most in other countries are comparatively cheaper in payment plans.

Public health is critical for society, including those who cannot afford treatment or, due to the expense, avoid treatment that could prevent a serious illness; one major problem in the United States, as I have already cited in several studies, is preventative care. People don't get preventative care because it's often unaffordable.

Even those people with insurance are affected, as a significant chunk of those who have insurance are part of the number of total medical bankruptcy filings.

Indeed this should be funded by the public for public safety if and only if those who need it cannot purchase it.


The programme itself, though, is subject entirely to the utility of testing for AIDS. If this will help people in sufficient numbers, it is worth it ethically. If not, then not. I do not know if testing would be worth it, mandatory (at least as specific intervals).

[Mayberry]

If that would prevent just one person from contrating this disease, think of how much money you would save in the long run. That always seems to be the precursor to every "public safety" thing that oozes down the pipe. It doesn't hold water with me. I shouldn't be paying for ANY of some one else's healthcare, weather it's a $2.50 test or $25,000 worth of surgery. Just as I shouldn't be forced to wear a seatbelt (I do anyway, but the principle if the thing pi$$es me off), I shouldn't be forced to evacuate 4 days before a hurricane "might" make landfall, I shouldn't be forced to spend $30,000 for a new car full of airbags and stability control systems and all that other crap that forces me to have to take it to the dealer to work on because I don't have a NASA supercomputer to diagnose the damn thing...... You see what I'm getting at? People should be responsible for their own selves as they were WAAAAAYYYYY back when. This day and age of Dr. Phil telling you "it's o.k., it's your Dad's fault, not yours" needs to end. Nobody's to blame for when they screw up, who needs a job because the gub'ment will take care of us, and the Dems eat it all up because that's exactly what they want, a country full of morons that are totally dependent on the government to wipe their arse for them. Keeps them gainfully employed, you see?

[lily]

hhhhmmmmmm all that, Mayberry..... because I think it's a good idea for the state to shell out two bucks for an AIDS test? Hell, there's plenty of things that I don't want my tax dollar to pay for, but until there are little boxes on our tax forms saying what we want our taxes to pay for, we're shit out of luck.

If you can't see how this measly two buck will save you thousands in the long run, not to mention maybe 10 lives that could be effected, then I really don't know what else to say.

[Cobra]

I don't want my tax dollars going to any shit head politicians salary can my two bucks go to this instead, pretty please with a cherry on top. I want a check box, oh wait I don't pay those type of taxes yet cuss I can't find a job, but anyway this doesn't sound like a bad idea to me.