WASHINGTON — Two years after the federal government recommended that patients in emergency rooms and doctors' offices routinely be tested for HIV, the advice is generally not being followed, scientists said Thursday.
While some small gains have been made, one in five people infected with the AIDS virus still don't know it, they said.
Eleven states that once required consent for HIV testing have changed their laws, a key step to making an HIV test part of the standard battery patients expect. But HIV specialists meeting Thursday said other barriers include physician confusion about the ease of today's tests, which can cost as little as $15.
No more than 100 of the nation's 5,000 emergency rooms routinely test for HIV in patients who aren't critically ill, said Dr. John Bartlett of Johns Hopkins University, who co-chaired the Forum for Collaborative HIV Research meeting. Yet because many HIV patients are poor or uninsured, ERs are the health care setting most likely to find them.
In 2006, the Centers for Disease Control and Prevention recommended that everyone 13 to 64 years old be routinely tested in medical encounters, with the choice to opt out.
Studies presented Thursday suggest more than 80 percent of emergency room patients were amenable to an HIV test.
Among the many reasons for the general neglect of the recommendations, the studies indicate, are the perception of many clinicians that it takes too much time and the reluctance of some insurers to pay for the tests.
"Reimbursement is a major barrier to routine testing," said Kevin Fenton, director of HIV prevention at the CDC.
While every pregnant woman is supposed to be tested so steps can be taken to protect her unborn baby, about 40 percent aren't, Bartlett said.