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1. CDC Recommendations and the Compendium of State HIV Testing Laws

   • Sarah E Neff, MPH
   • Ronald H. Goldschmidt, MD

   University of California, San Francisco

   We read with great interest the article by Mahajan, et al., “Consistency of State Statutes with the Centers for Disease Control and Prevention HIV Testing Recommendations for Health Care Settings” (1). As the authors state, there has been little discourse on the evolution of state HIV testing laws since the issuance of the 2006 CDC recommendations (2), leaving many clinicians confused about their state-specific guidelines and whether they conform with the CDC recommendations.

   We are concerned that the article can be misinterpreted by clinicians seeking guidance in this difficult arena. For example, Mahajan et al. classify Alabama as inconsistent with CDC recommendations because its laws require “specific, written consent;” however, Alabama’s statutes also specify that consent may be included in general consent for medical or surgical treatment, which can be interpreted as “consistent.” Moreover, there are differences within state laws pertaining to different testing scenarios for different populations (e.g., pregnant women, minors), facilities (e.g., emergency departments, counseling and testing sites, substance abuse treatment centers), health care providers, (e.g., physicians, nurses, physicians’ assistants) that are not specified in the article, further complicating matters for clinicians.

   The Compendium of State HIV Testing Laws from the National HIV/AIDS Clinicians’ Consultation Center (NCCC) at www.nccc.ucsf.edu can help clinicians seeking clarification of how their state laws and the CDC recommendations apply in clinical practice. The Compendium comprehensively presents clinicians with regular updates to each state’s HIV testing laws. Since Mahajan, et al. cited the Compendium, it has already undergone three major updates, illustrating the benefit of such a living document.

   References:

   1. Mahajan AP, Stemple L, Shapiro MF, King JB, and Cunningham WE. Consistency of state statutes with the Centers for Disease Control and Prevention HIV testing recommendations for health care settings. Ann Intern Med. 2009;150:263-269.

   2. Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al; Centers for Disease Control and Prevention (CDC). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55:1-17; quiz CE1-4. [PMID:16988643]

   Conflict of Interest:

   None declared

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   Published March 18, 2009