Back in 2006, the Centers for Disease Control and Prevention called for virtually all patients younger than 65 admitted to hospitals or seen in primary care and emergency rooms to be routinely tested for HIV on an opt-out basis. To be more explicit, patients should automatically be tested unless they specifically refuse. However, things don’t look too good today, two years after the recommendation was made.

The Forum for Collaborative HIV Research, an independent public-private partnership based at the George Washington University School of Public Health and Health Services, found that only about 5 percent of patients with evidence of serious illness are being routinely checked in hospital emergency rooms for HIV, the virus that causes AIDS.

“HIV is a life-threatening disease that is so grossly underdiagnosed and undertreated in this country. Testing for HIV should be as routine as a flu shot. A few hospital are implementing routine testing in their emergency departments, but these are few and far between,” Veronica Miller, director of the Forum for Collaborative HIV Research said in a briefing on the two-day Summit on HIV Testing in Washington. The Summit focused on the extent of HIV testing in the United States and how it could be improved.

More exactly, about 50 to 100 out of 5,000 emergency rooms in the US are routinely testing all patients for HIV, according to Richard Rothman, M.D., Ph.D., of Johns Hopkins. Every pregnant women is supposed to be tested so steps can be taken to protect her unborn baby. However, about 40 percent aren’t.

The reasons for which patients are not routinely tested for HIV vary. Among them are the perception of many clinicians that it takes too much time and the reluctance of some insurers to pay for the tests.

“Reimbursement is a major barrier to routine testing,” Kevin Fenton, director of HIV prevention at the CDC, said. The testing consists of a saliva test, followed if possible by a confirmatory blood test. If a patient is charged, the cost is about $80 to $120.

Diagnosing a person with HIV in its early phase is very important both for that person and for those whom he/she comes in contact with. Treatment delays can lead to immune system damage and higher risk of cancer and heart disease, Miller said.

The HIV-infected population in the US rose to 1.1 million in 2006 from an estimated 994,000 in 2003, meaning that since 2003, HIV prevalence has increased by 11 percent, or 112,000 people, according to a study of the CDC released at the beginning of October.

The CDC previously reported that more people are becoming infected each year than previously estimated, with 56,300 new HIV infections in the US in 2006. Previous estimates put the number of new infections at about 40,000 a year.

Since 1981, when AIDS first came to public notice, the disease has killed at least 25 million people, and 33 million others are living with the disease or HIV.