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Revised Guidelines for HIV Counseling, Testing, and Referral
Revised Recommendations for HIV Screening of Pregnant Women
On November 9, 2001, CDC published both the Revised Guidelines for HIV Counseling, Testing, and Referral as well as the
Revised Recommendations for HIV Screening of Pregnant Women. The new Guidelines and Recommendations
replace guidelines previously issued by CDC and the Public Health Service (PHS).
Guidelines for HIV Counseling, Testing, and Referral
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Revised Recommendations for HIV Screening of Pregnant Women
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HIV/AIDS
Recommendations and Guidelines
The Revised Guidelines for HIV Counseling, Testing, and Referral include the following significant revisions:
- Providing guidance to all providers of voluntary HIV CTR (both in the public and private sectors).
- Underscoring the importance of early knowledge of HIV status by 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.
- Addressing ways to improve the quality and provision of HIV CTR.
Critical aspects of the previous CDC HIV CTR guidelines that are unchanged include:
- Encouraging the availability of anonymous as well as confidential HIV
testing. Ensuring that HIV testing is voluntary, informed, and consented-based.
- Emphasizing access to testing and appropriate disclosure of test results.
- Advocating routinely offered HIV CTR in settings that serve clients at increased behavioral or clinical risk for HIV infection (e.g., publicly funded clinics).
- Recommending use of a prevention counseling approach aimed at personal risk reduction for HIV-infected persons and persons at increased risk for HIV.
- Stressing the need to provide information regarding the HIV test to all who take the test.
The Revised Recommendations for HIV Screening of Pregnant Women will replace the U.S. Public Health Service Recommendations for Human Immunodeficiency Virus Counseling and Testing for Pregnant Women, 1995. Major revisions to the 1995 recommendations include:
- Emphasizing HIV testing as a routine part of prenatal care.
Strengthening the recommendation that all pregnant women be tested for HIV.
- Recommending simplification of the testing process and making the consent process more flexible.
- Recommending that providers explore and address reasons for refusal of testing.
- Emphasizing HIV testing and treatment at the time of delivery for women who have neither received prenatal testing nor antiretroviral drugs, if HIV-positive.
Important aspects of the recommendations that remain unchanged include:
- Ensuring that HIV testing of pregnant women and their infants should be voluntary and informed.
- Emphasizing that health-care providers should perform HIV testing as early as possible during pregnancy to promote informed and timely therapeutic decisions.
- Emphasizing the importance of follow-up medical care for HIV-infected mothers and perinatally-exposed children.
- Recommending that HIV-infected pregnant women receive prevention counseling.
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