At the end of 2006, an estimated 1,106,400 persons (range: 1,056,400 – 1,156,400) in the United States were living with HIV. CDC estimates that 56,300 new HIV infections occurred in the United States in 2006 (1).

Each year, approximately 16-22 million persons in the United States are tested for HIV. By 2002, an estimated 38%-44% of all adults had been tested for HIV (3). However, at the end 2006, approximately 1 in 5 (21%, or 232,700 persons) did not know they were infected (4).

HIV testing is entering a new era in this country as lawmakers, health care and insurance executives, and public health officials are making changes in their respective fields to ensure that more people will know their HIV status – an important consideration for maintaining health and reducing the spread of the virus.

In September 2006, CDC released Revised Recommendations for
HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. These new Recommendations, which replace CDC's 1993 Recommendations for HIV Testing Services for Inpatients and Outpatients in Acute-Care Hospital Settings, advise routine HIV screening of adults, adolescents, and pregnant women in health care settings in the United States. They also recommend reducing barriers to HIV testing. See CDC Response for more information on the revised testing recommendations.

Rationale for Routine Screening for HIV Infection

People who are infected with HIV but not aware of it are not able to take advantage of the therapies that can keep them healthy and extend their lives, nor do they have the knowledge to protect their sex or drug-use partners from becoming infected. Knowing whether one is positive or negative for HIV confers great benefits in healthy decision making.

Cohort studies have demonstrated that many infected persons decrease behaviors that help transmit infection to sex or needle-sharing partners once they are aware of their positive HIV status (5-12). HIV-infected persons who are unaware of their infection do not reduce risk behaviors (13,14,15). Persons tested for HIV who do not return for test results might even increase their risk for transmitting HIV to partners (16). Because medical treatment that lowers HIV viral load might also reduce risk for transmission to others (17), early referral to medical care could prevent HIV transmission in communities while reducing a person's risk for HIV-related illness and death.