Page 285 - AIDSBK23C

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and the need for psychological and social support services.[251] A significant problem is the
failure of persons tested to return for results. The use of rapid HIV testing for screening (results
in less than an hour) leads to a greater number of new HIV infections detected and in fewer
patients leaving before test results are obtained.[1119]
Pregnant women represent an important group for whom HIV testing can provide
considerable benefit. This is because of the significant reduction in perinatal HIV transmission
that can be accomplished by giving mothers-to-be antiretroviral therapy.[185]
Mandatory testing remains controversial. The stigma associated with a diagnosis of HIV
infection continues to prevent infected persons from being treated similar to patients with most
other illnesses. This makes HIV testing less than routine. In the U.S., mandatory testing has
been applied to personnel in the armed forces, Foreign Service personnel, immigrants, and
certain sex offenders. Other jurisdictions, including some of the individual states in the U.S.,
have mandated testing for additional populations, including prisoners and newborns. Many
states provide for compulsory testing of patients to determine their HIV status when an injury to
a health care worker may involve possible HIV transmission.[1110]
In the U.S., the results of HIV testing for medical purposes are generally held to be
confidential. Most states have laws protecting confidentiality of HIV-related information.
However, all states require reporting of all patients diagnosed with AIDS to governmental health
departments, though little more than half of the states require similar reporting for HIV infection.
A “duty to warn” other persons, including spouses and sex partners, regarding a patient’s HIV
positivity by health care providers is specifically permitted by law in some states, though the
courts have ruled that the health care provider has a duty to warn persons at risk for
infection.[1110]