The State of Prevention
Not long ago, getting an HIV test could be a real pain. Even after setting aside all the accompanying anxieties and fears and stigmas, it was just a hassle.
First, you'd come in for the
The State of Prevention
Not long ago, getting an HIV test could be a real pain. Even after setting aside all the accompanying anxieties and fears and stigmas, it was just a hassle.
First, you'd come in for the test -- and unless you went to a private doctor's office, this often meant an uncomfortable and nerve-wracking wait in a lobby full of nervous people. Then you had to sit through a talk with an HIV counselor, who would ask all kinds of personal questions about what you'd done to put yourself at risk for contracting the virus. Then there was the poking and prodding with needles to draw your blood.
But that wasn't the end. There was still the agonizing wait -- as long as two weeks -- while your blood shipped off to a lab to get tested. Then you had to go back to the doctor or clinic and, once more, sit in a waiting-room purgatory before finally getting your test results.
It was a lot to deal with.
And a lot of people never made it through the process: The U.S. Centers for Disease Control and Prevention has long estimated that a third of all people who get tested never claim their results.1
So for years, health departments and testing-technology developers have been working to ease this process. Gradually, new technologies have become available and, in turn, public health officials have adapted guidelines to streamline HIV testing in America. But in 2006, the CDC approved reforms that may represent the most significant overhaul of HIV testing the United States has ever seen.
The agency's move was greeted with a mixture of praise and damnation. Few challenged its overarching goal of making HIV testing an easily accessible, routine part of health care. But many, including the Institute, have questioned whether the CDC's initiative goes too far and, thus, misses a crucial point: testing is not a silver bullet to slay AIDS. Without a similarly robust commitment to the far broader and far more difficult prevention work needed to help individuals and communities make healthy choices, no amount of testing will stop the virus' spread.
Check EverybodyThe federal government maintains a wide range of official public health guidelines that, while not legally binding, offer care providers detailed recommendations on how a given procedure should be handled and carry the weight of the government's approval -- which, in some cases, is needed to access federal funding. There are guidelines for stuff ranging from diagnosing fetal alcohol syndrome to prescribing anti-HIV medicines. And since 1985, there have been guidelines for how HIV tests should be conducted. In September 2006, the CDC completed a rewrite of those guidelines as part of its ongoing campaign to boost the number of people who know their HIV status.2 (See "Standardized Testing Revisited" on page 26.)
The percentage of American adults who have gotten HIV tests in their lifetime has steadily grown since 1987, according to surveys. However, the share of adults who have been tested in the previous 