Routine opt-out HIV testing

Because of concerns that an estimated one-quarter of HIV-positive individuals in the USA are unaware they are infected, the Centers for Disease Control and Prevention (CDC) has recently published revised HIV-testing guidelines.1 The guidelines recommend routine HIV testing in all health-care settings in patients aged 13-64 years, with notification that testing is done unless patients opt out. Brief behavioural-risk screenings can be used to help identify patients for further risk assessment, risk-reduction counselling, and other interventions.7,8 Short counselling interventions with personalised risk-reduction plans can be effective, even for busy clinics.9 Risk information is also needed because the CDC recommends that HIV testing of high-risk individuals be done at least yearly.1 HIV testing could provide the only opportunity to communicate crucial risk-reduction information.