What are the policy and public health implications of the CDC's new HIV testing guidelines

In September 2006, the CDC issued new guidelines for HIV testing in health-care settings. A key departure from previous guidelines was the recommendation that health-care providers should routinely screen all patients for HIV, unless they have data showing that their diagnostic yield is less than one in 1,000. At Boston Medical Center, the limited HIV testing resources are allocated in a targeted way. In some parts of the hospital, HIV testing is highly targeted, while elsewhere a modified form of routine testing is in place. The goal with this approach is to maximize resources and ensure linkage to HIV services. The example of Boston Medical Center suggests that health-care settings elsewhere would benefit from considering the resource and patient care implications of implementing routine HIV testing.