ACOG Recommends Routine HIV Testing for All Women Ages 19-64, Regardless of Individual Risk Factors

Obstetricians and gynecologists should routinely screen all women between the ages of 19 and 64 for HIV, regardless of their personal risk factors, according to a committee opinion, Routine Human Immunodeficiency Virus Screening, issued this week by the American College of Obstetricians and Gynecologists (ACOG), a national medical organization representing over 52,000 members who provide health care for women.

Implementation of this screening recommendation will be a dramatic shift for some OB-GYN practices, especially those that currently test only pregnant women, 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. According to ACOG, this knowledge can improve women's chances of survival, reduce associated illnesses, protect their sexual partners, help them take steps to avoid unintended pregnancy, and reduce the risk of mother-to-child HIV 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 a patient is notified that HIV testing will be performed as a routine part of her gynecologic and obstetric care unless she declines. Neither specific signed consent forms 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.

8/08/08

Sources

American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No. 411: Routine Human Immunodeficiency Virus Screening. Obstetrics and Gynecology 112: 401-403. DATE, 2008.

American College of Obstetricians and Gynecologists. Routine HIV Screening Recommended for All Women, Regardless of Individual Risk Factors. Press Release. August 1, 2008.