Many at Risk for HIV Not Being Tested(icine . For the study Pence's team an...),Health

For the study, Pence's team analyzed health surveys of 146,868 Americans and found that people at high risk for HIV tended to say they wanted to be tested but didn't follow through. Twenty-seven percent of those at highest risk said they wanted to be tested within the next year, but only 11 percent had actually had a recent test.

The researchers also found that about 44 percent of the tests taken came during regular patient visits, such as prenatal care visits or other routine medical appointments. This finding supports the belief that incorporating HIV testing into routine medical care helps make testing more available, the researchers said.

David Paltiel, an associate professor of public health at the Yale School of Public Health, agrees that HIV testing should be a part of general medical care. "It's true that we aren't testing enough people," he said. "The high risk groups have really bad follow-up, really bad linkage to care, really bad access to health care.

"Even these at-risk groups come into contact with a primary health care setting, and making it a routine part of care is the answer," he said.

Paltiel admits there are legal, political and financial problems to be overcome before HIV testing becomes routine.

Philip Alcabes, an associate professor in the School of Health Sciences at Hunter College in New York City, thinks any policy for HIV testing needs to balance privacy issues with the desire to find infected people in order to treat them.

"Making testing available in some routine way makes some sense if your goal is to find more cases and get treatment to people," Alcabes said. "But there are people who are very concerned about people knowing they have HIV. That's a reasonable concern that needs to be respected. There are people who don't want their names on lists."

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