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Routine HIV Screening Recommended for All Women, Regardless of Individual Risk Factors

August 1, 2008

Washington, DC -- Ob-gyns should routinely screen all women between the ages of 19 and 64 for HIV, regardless of their risk factors, according to a Committee Opinion, Routine Human Immunodeficiency Virus Screening, issued today by The American College of Obstetricians and Gynecologists (ACOG). Implementation of this screening recommendation will be a dramatic shift for some ob-gyn practices, especially those that are currently testing only pregnant patients, patients at high risk, and/or upon patient request.

"Women represent the fastest growing population of persons infected with HIV in this country, and heterosexual transmission has become a much bigger factor," according to Denise J. Jamieson, MD, MPH, chair of ACOG's Committee on Gynecologic Practice. "There are two basic messages for patients: Every woman should know her HIV status, and it's a simple test."

It is estimated that one-quarter of all Americans with HIV are unaware of their status. Women continue to represent a growing proportion of HIV and AIDS cases, and it's critical that they know their status. According to ACOG, this knowledge can improve women's chances of survival, reduce associated illnesses, help them take steps to avoid unintended pregnancy, protect their sexual partners, and reduce the likelihood of mother-to-child transmission should pregnancy occur.

"ACOG recommends routine HIV screening for all women ages 19 to 64, regardless of pregnancy status or what their risk factors might be," Dr. Jamieson said. "ACOG also recommends targeted screening for women outside this age range who are at high risk. For example, all sexually active teenagers under 19 should be tested, as well as women older than 64 who have had multiple partners in recent years."

Today's recommendation on HIV screening emphasizes 'opt-out' testing as the preferred approach. Opt-out testing is when the patient is notified that HIV testing will be performed as a routine part of her gynecologic and obstetric care unless she declines testing. Neither specific signed consent nor prevention counseling is required with opt-out testing. However, many state and local laws are not consistent with opt-out testing and may require informed consent or counseling.

Committee Opinion #411, "Routine Human Immunodeficiency Virus Screening," is published in the August 2008 issue of Obstetrics & Gynecology.

The American College of Obstetricians and Gynecologists is the national medical organization representing over 52,000 members who provide health care for women.