Two years after the Centers for Disease Control and Prevention recommended that patients in emergency rooms and doctor’s offices be routinely tested for HIV, the advice is not being followed, according to a study by the Forum for Collaborative HIV Research, an independent public-private partnership based at the George Washington University School of Public Health and Health Services. The study was presented during a two-day Summit on HIV Testing in Washington, which focused on the extent of HIV testing in the United States and how it could be improved.

The organization 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.

“While significant progress has been made in the two years since the U.S. Centers for Disease Control and Prevention recommended routine testing, we are still nowhere near this being the national norm,” said Veronica Miller, executive director of the Forum for Collaborative HIV Research. “Testing for HIV should be as routine as a flu shot,” she added.

According to 2006 data shared at the conference by Dr. Richard Rothman, associate professor in Hopkins' emergency medicine department, emergency rooms tested patients at a rate of 3.2 per 1,000 visits. “There are many missed opportunities in recognizing patients earlier in the course of their illness.”

Dr. Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention said that HIV testing is a life-and-death issue. “Once people learn they are infected with HIV, they take steps to protect their partners.”

But the reality is that many people live with HIV without even knowing it. About one in five people who have HIV doesn’t know about it, risking his/her life and the others’ as well. A person who is HIV-positive, but unaware they are infected, is three times more likely to transmit the infection than a person who is aware they have it.

What are the reasons behind this situation? The perception of many clinicians that it takes too much time and the reluctance of some insurers to pay for the tests are the most important.

Also studies presented during the summit suggest more than 80 percent of emergency-room patients were amenable to an HIV test while most emergency room workers opposed testing them. Why? Presumably because emergency rooms are so busy and there's confusion about how much HIV counseling is needed.

UNAIDS estimates the HIV virus has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive pandemics in recorded history. Currently, there are 33 million living with AIDS, 5.5 million of whom being located in South Africa. More than 6,500 new HIV infections occur daily worldwide, and about 1,000 of these in South Africa.