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PUBLIC HEALTH & EDUCATION | ACOG Releases New Recommendations on HIV Screening for Women

PUBLIC HEALTH & EDUCATION | ACOG Releases New Recommendations on HIV Screening for Women
[Aug 5, 2008]

Physicians need to make an increased effort to encourage minority women to get tested for HIV because they are at greater risk of contracting the virus, according to new recommendations issued by the American College of Obstetricians and Gynecologists, HealthDay/U.S. News and World Report reports (HealthDay/U.S. News and World Report, 8/1). A separate recommendation by ACOG also says that ob-gyns should routinely screen all women ages 19 to 64 for HIV regardless of individual risk factors. Targeted screening is also recommended for women who are outside this age range but at high risk of HIV/AIDS.

The recommendations, issued by ACOG's Committee on Gynecology Practice, are published in the August issue of the journal Obstetrics and Gynecology. The committee also recommends "opt-out" testing, in which patients are told that HIV tests will be given as part of routine care, unless they decline. Neither specific signed consent nor HIV prevention counseling is required under opt-out testing. According to an ACOG release, some state and local laws are not consistent with the opt-out testing and might require additional counseling or informed consent requirements.

Denise Jamieson, chair of the committee, said, "Women represent the fastest growing population of persons infected with HIV in this country, and heterosexual transmission has become a much bigger factor." She added, "There are two basic messages for patients: Every woman should know her HIV status, and it's a simple test." ACOG also said that knowing their HIV/AIDS status helps women take steps to avoid unintended pregnancy, protect their sexual partners and reduce the likelihood of mother-to-child transmission of HIV should pregnancy occur.

According to the release, the recommendations 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 patients upon request" (ACOG release, 8/4).

Heather Watts, a liaison member to ACOG's Committee on Health Care for Underserved Women, said, "Rates of infection among African-Americans -- and also among Hispanics -- are much higher than among white women. Sixty-four percent of women with HIV are black, even though blacks only make up about 13% of the U.S. population." She added, "Education plays an important role. ... All women should understand how to protect themselves, such as limiting their number of partners and using condoms consistently" (HealthDay/U.S. News and World Report, 8/1).