Incorporating HIV Testing into Routine Health Care

Quick Reference Table

Population or Setting Recommendation
Patients with no known risk in low prevalence areas Discuss and offer HIV testing
All Pregnant Women, regardless of risk or geographic setting**

Present HIV testing as a clinical recommendation; emphasize availability of prophylaxis to prevent transmission to infant.

Present testing as early as possible during the pregnancy.

A repeat third trimester test should be recommended to pregnant women at high risk* for acquiring HIV.**

*Criteria include: 1) history of STD(s); 2) substance use or exchange of sex for money/drugs; 3) multiple sex partners during pregnancy or sex with partner(s) known to be HIV-positive or at high risk for acquiring HIV.

*Routine universal retesting in the third trimester should be considered in health-care facilities with high HIV seroprevalence among women of childbearing age.

*At any time during pregnancy, immediate testing should be recommended to all women with signs and symptoms suggestive of acute HIV infection using HIV RNA (viral load) testing in addition to HIV antibody testing when acute HIV infection is suspected.

Health care settings serving people at high risk

Present HIV testing to all patients as a clinical recommendation in the following settings:

  • Designated AIDS Centers
  • Urgent Care Centers
  • STD clinics
  • Correctional Facilities
  • Community health clinics
  • Substance Use Programs
  • Family Planning Programs
  • Emergency Rooms

People at elevated risk, including:

  • sexually active people, and
  • people with a history of substance use

Present HIV testing as a clinical recommendation whenever a patient discloses risk.

Since many people choose not to disclose risk, adopt a low threshold for recommending the test.

 

**Since each year a number of pregnant women in New York become infected with HIV late in pregnancy, the Department is currently working with the American College of Obstetricians and Gynecologists (District II) to develop recommendations on routine repeat testing in the third trimester of pregnancy.