Christine Lubinski, HIV Medicine Association, Infectious Diseases Society of America
Judith Aberg, Bellevue Hospital Center, New York University Medical SchoolFollow
Arlene D Bardeguez, University of Medicine and Dentistry–New Jersey Medical School
Richard Elion, Elizabeth Taylor Medical Center
Patricia Emmanuel, University of South Florida
Daniel Kuritzkes, Brigham and Women's Hospital, Harvard Medical School
Michael Saag, University of Alabama at BirminghamFollow
Kathleen E Squires, Thomas Jefferson UniversityFollow
Andrea Weddle, HIV Medicine Association, Infectious Diseases Society of America
Jennifer Rainey, HIV Medicine Association, Infectious Diseases Society of America
M Renee Zerehi, American College of Physicians
J Fred Ralston, Fayetteville Medical Associates
David A Fleming, University of Missouri Center for Health Ethics, University of Missouri School of Medicine
David Bronson, Cleveland Clinic Medicine Institute
Molly Cooke, Halle T. Debas Academy of Medical Educators, University of California
Charles Cutler, American College of Physicians
Yul Ejnes, Coastal Medical, Cranston, Rhode Island
Robert Gluckman, Graduate Medical Education Clinics, Providence Physician Division
Mark Liebow, Mayo Clinic, Rochester, Minnesota
Kenneth Musana, American College of Physicians
Mark E Mayer, General Internal Medicine, Cleveland Clinic
Mark W Purtle, Central Iowa Hospital Corporation
P Preston Reynolds, American College of Physicians
Lavanya Viswanathan, Uniformed Services University of the Health Services
Kevin B Weiss, American Board of Medical Specialists
Baligh Yehia, Johns Hopkins University

Document Type


Publication Date



This article has been peer reviewed. It was published in Clinical and Infectious Diseases.

Volume 48, Issue 10, May 2009, Pages 1335-44.

The published version is available at DOI: 10.1086/598169. Copyright © Oxford University Press


Executive Summary

The American College of Physicians (ACP) and the Infectious Diseases Society of America (IDSA) have jointly published 3 policy statements on AIDS, the first in 1986 [1], the second in 1988 [2], and the third in 1994 [3]. In 2001, the IDSA created the HIV Medicine Association (HIVMA), and this updated policy paper is a collaboration between the ACP and the HIVMA of the IDSA. Since the last statement, many new developments call for the need to reexamine and update our policies relating to HIV infection. First, there have been major advances in treatment for HIV infection that have transformed HIV/AIDS from a terminal illness to a chronic disease for many of those who have access to potent therapies and expert medical care [4]. Second, there has been a profound expansion and intensification of the global HIV pandemic, particularly in sub-Saharan Africa, coupled with significant US leadership and resources aimed at providing prevention and care services to affected populations in developing countries. Third, the concerns that were prevalent in the mid-1990s regarding the possibility of HIV transmission in health care settings have ultimately proven to be unfounded as the result of the adoption of universal precautions in those settings.

In this article, we emphasize the public health and clinical imperatives for earlier identification of persons with HIV infection; the urgent need to expand access to state-of-the-art HIV care and treatment for infected individuals; the need for access to comprehensive prevention and education for those living with and those at risk for HIV infection; and the need for stronger national leadership to respond to the HIV epidemic in the United States and in the developing world.

In December 2008, the ACP and HIVMA released a guidance statement on screening for HIV infection in health care settings that recommended that clinicians adopt routine screening for HIV infection and encourage patients to be tested. Also included in the guidance statement is a recommendation that clinicians determine the need for additional screening on an individual basis.

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