Dec. 1 (Bloomberg) -- Just two weeks after a study showed routine HIV testing recommended by the U.S. government isn’t done at most hospitals, a doctor’s group lent added support to universal screening for those over age 13.

The recommendations from the American College of Physicians, whose 126,000 members are internists, are similar to guidelines issued in 2006 by the U.S. Centers for Disease and Prevention. The study, led by Richard Rothman of Johns Hopkins University in Baltimore, found that only about 100 of 5,000 U.S. emergency rooms have implemented CDC test guidelines.

Until 2006, the CDC only urged testing people at high risk of getting HIV, and those with symptoms. In 2006, the agency rejected that idea and said requirements for written patient consent and pretest counseling endangered public health because people who unknowingly carry the disease weren’t being identified. The college now says it agrees with that approach.

The college encourages “their patients to get tested, regardless of their risk factors,” said Amir Qaseem, a senior medical associate for the college and lead author of the guidelines reported today on the Web site of the Annals of Internal Medicine.

Frequent testing should be offered to patients who are considered to have a higher-than-average risk, the college’s new guidelines said. High-risk people include those who use drugs intravenously and share the needles, those who have unprotected sex with multiple partners or those who had a blood transfusion from 1978 to 1985.

Other Doctors Support

The college joined three other doctors’ groups --the American Academy of Family Physicians, the American College of Emergency Physicians and the American College of Obstetricians and Gynecologists -- that have endorsed the CDC guidelines.

About 1.1 million people in the U.S. are infected with HIV and one in five doesn’t know it, according to the Atlanta-based CDC. About 20,000 new infections occur each year in the U.S. when people who carry the virus without knowing it spread it to others, according to the college.

“The intent of this guideline is to help prevent the unwitting spread of HIV infection,” Vincenza Snow, an internist at a free clinic in Philadelphia and director of clinical programs and quality of care at the American College of Physicians, said in a statement. “I would tell my patients that it’s important to know your HIV status so that you do not risk infecting anyone else.”

The Johns Hopkins study found testing isn’t done at most hospitals and clinics because some insurers won’t pay and many doctors are wary of spending time on it.

Large private insurers, such as UnitedHealth Group Inc., Aetna Inc. in Hartford, Connecticut, and Cigna Corp. of Philadelphia, began covering routine testing soon after the guidelines were announced. Many smaller insurers and federal programs such as Medicare and the Federal Health Employees Benefit program don’t pay for routine HIV testing, said Kevin Fenton, CDC’s director of AIDS prevention.

About 40 states have changed laws so that patients can be tested without advance counseling, Branson said. Seven that haven’t -- Hawaii, Massachusetts, Nebraska, New York, Pennsylvania, Rhode Island and Wisconsin -- have unsuccessfully proposed legislation to remove the counseling requirement. California and Illinois also still have the requirements in place.

To contact the reporter on this story: Rob Waters in San Francisco at rwaters5@bloomberg.net.

Last Updated: December 1, 2008 07:24 EST