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Revised guidelines for HIV counseling, testing, and referral ; and Revised recommendations for HIV screening of pregnant women
  • Published Date:
    November 9, 2001
  • Status:
    current
Filetype[PDF - 482.75 KB]


Details:
  • Corporate Authors:
    National Center for HIV, STD, and TB Prevention (U.S.), Division of HIV/AIDS Prevention--Surveillance and Epidemiology ; Centers for Diseases Control and Prevention (U.S.) ;
  • Series:
    MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports ; v. 50, no. RR-19
  • Document Type:
  • Description:
    Revised guidelines for HIV counseling, testing, and referral: "These guidelines replace CDC's 1994 guidelines, HIV Counseling, Testing, and Referral Standards and Guidelines, and contain recommendations for public- and private-sector policy makers and service providers of human immunodeficiency virus (HIV) counseling, testing, and referral (CTR). To develop these guidelines, CDC used an evidence-based approach advocated by the U.S. Preventive Services Task Force and public health practice guidelines. The recommendations are based on evidence from all available scientific sources; where evidence is lacking, opinion of "best practices" by specialists in the field has been used. This revision was prompted by scientific and programmatic advances in HIV CTR, as well as advances in prevention and the treatment and care of HIV-infected persons. These advances include a) demonstrated efficacy of HIV prevention counseling models aimed at behavioral risk reduction; b) effective treatments for HIV infection and opportunistic infections; c) effective treatment regimens for preventing perinatal transmission; and d) new test technologies. Although the new guidelines include many aspects of the previous ones (e.g., encouragement of confidential and anonymous voluntary HIV testing, need for informed consent, and provision of HIV prevention counseling that focuses on the client's own risk), the new guidelines differ in several respects, including: giving guidance to all providers of voluntary HIV CTR in the public and private sectors; using an evidence-based approach to provide specific recommendations for CTR; underscoring the importance of early knowledge of HIV status and making testing more accessible and available; acknowledging providers' need for flexibility in implementing the guidelines, given their particular client base, setting HIV prevalence level, and available resources; recommending that CTR be targeted efficiently through risk screening and other strategies; and addressing ways to improve the quality and provision of HIV CTR." -p.1

    Revised recommendations for HIV screening of pregnant women: "These guidelines replace CDC's 1995 guidelines, U.S. Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Voluntary Testing for Pregnant Women, and are for public- and private-sector service providers who provide health care for pregnant women. In 1998, the Institute of Medicine (IOM) published a report that recommended simple, routine, and voluntary human immunodeficiency virus (HIV) testing for all pregnant women in antenatal settings, given the effective interventions available to treat HIV-infected women and reduce risk for perinatal HIV transmission. In 1999, CDC convened consultation groups to discuss and comment on the IOM report. These guidelines are based on input from these meetings, the IOM report, and public comment on draft guidelines published in Fall 2000 in the Federal Register. These guidelines were also prompted by scientific and programmatic advances in the prevention of perinatally acquired HIV and care of HIV-infected women. These recommendations are consistent with the Revised Guidelines for HIV Counseling, Testing, and Referral. Major revisions from the 1995 guidelines include: emphasizing HIV testing as a routine part of prenatal care and strengthening the recommendation that all pregnant women be tested for HIV; recommending simplification of the testing process so that pretest counseling is not a barrier to testing; making the consent process more flexible to allow for various types of informed consent; recommending that providers explore and address reasons for refusal of testing; and emphasizing HIV testing and treatment at the time of labor and delivery for women who have not received prenatal testing and antiretroviral drugs. These guidelines recommend voluntary HIV testing to preserve a woman's right to participate in decisions regarding testing to ensure a provider-patient relationship conducive to optimal care for mothers and infants and to support a woman's right to refuse testing if she does not think it is in her best interest." - p.63

  • Supporting Files:
    No Additional Files