IDPH clarifies HIV recommendations

Posted March 31, 2008

In late December and early January, the Iowa Department of Public Health (IDPH) mailed health care providers a brochure entitled “HIV Testing and Iowa Law.” It described current Iowa law governing HIV testing and reporting. It also indicated that the Centers for Disease Control and Prevention (CDC) had revised its recommendations for HIV testing.

IDPH received feedback, including questions about required HIV testing. Health care providers in Iowa must offer HIV testing and education to any persons at risk for HIV infection, as outlined in Iowa Code 141A.4. The groups described in the statute: persons who test positive for a sexually transmitted disease; persons with a history of injection drug use; male and female sex workers or those who trade sex for drugs, money or favors; sexual partners of HIV-infected persons; and persons whose partners engage in the behaviors just listed. Routine testing of all persons is not required.

The revised recommendations from the CDC advise routine HIV testing in patients 13 to 64 years of age when the patient population has a prevalence of undiagnosed HIV that has been documented to be at least 1 per 1,000 patients screened. It is believed that the overall Iowa rate is below this. However, those providers whose patient population is known to have high rates of the above risk factors or other known risk factors for HIV may have rates over 1 per 1,000. These providers may want to consider routine testing of patients in this age range.

IDPH is currently conducting a study on the number of undiagnosed HIV-positive people in Iowa. Additional copies of the IDPH brochure are available at www.idph.state.ia.us/adper/hiv_aids_programs.asp#legislation. Questions on this issue may be addressed to Randy Mayer, IDPH HIV/AIDS/Hepatitis Program Manager, at rmayer@idph.state.ia.us.