Despite widely available testing, about a quarter of the Americans infected with H.I.V. don't know it. Those who are unaware of their infections can spread then unknowingly. They also miss out on powerful drug therapies that have been shown to extend lives, while protecting infected people from the diseases to which H.I.V. makes them prone.
Rapid AIDS tests — which have cut the waiting time for results to 20 minutes from as much as two weeks — have greatly helped the outreach effort. But the Centers for Disease Control and Prevention will take another important step forward this summer when it offers new guidelines for AIDS testing. The proposed recommendations are a sea change in the testing regimen, suggesting that doctors offer the tests not just to people at risk, but as part of routine medical care for all patients ages 13 to 64.
The C.D.C. will also address two current obstacles to treatment. First, the agency will recommend that health care providers shorten and simplify a counseling session that often takes place before the person is tested. In addition, the new guidelines will suggest that patients be allowed to give oral consent to testing — rather than being required to sign a separate permission form.
AIDS activists have long insisted on the separate form, worried that patients might be tricked into taking a test that they might ordinarily shun, and perhaps expose infected people to discrimination. Such worries have proved unfounded; health authorities have demonstrated that they can be trusted to keep the information confidential. Moreover, it makes perfectly good sense to treat AIDS like any other infectious or sexually transmitted disease, especially given the wide availability of lifesaving treatment today.
