HIV Testing for All Women

The next time you see your gynecologist, you might get an HIV test along with your Pap smear. The American College of Obstetricians and Gynecologists recommended today that all women ages 19 to 64 get tested for HIV because one quarter of those who carry the virus responsible for AIDS aren't aware of it. Sexually active teens and older women engaging in sex with a new partner should also get tested, says ACOG. "We recommend that every woman get screened at least once and have repeat testing based on her risk factors, like multiple sex partners, injection drug use, or engaging in sex with a new partner," says gynecologist Denise Jamieson, chair of ACOG's Committee on Gynecologic Practice. Up until now, only pregnant women—to prevent transmission to the fetus—and those at increased risk were routinely tested.

Today's rapid HIV tests make the process far simpler than the intravenous blood test I had during my pregnancies in the 1990s. They involve either a finger prick to get a blood sample or a mouth swab to collect saliva, both of which are pretty painless. Their biggest plus: You get results in about 20 minutes, before leaving the doctor's office. (I had to wait a week for mine.) A positive rapid result showing HIV infection, however, needs to be confirmed with a traditional blood test because a small number of positive results turn out to be false, as my colleague January W. Payne previously reported.

The new recommendation reflects the growing proportion of women who carry the HIV virus, says Jamieson. What started out as an epidemic among gay men has become an equal-opportunity disease striking all populations, and most women get it by having heterosexual sex with infected partners. Black women, in particular, are at heightened risk: AIDS is the leading cause of death for those between 25 and 34 years old, according to a new report issued this week by the Black AIDS Institute. And black women face particular challenges, contends Helene Gayle, a public health physician and president of the antipoverty group CARE, in a statement responding to the report. Too many submit to unprotected sex with men whom they know are infected. "Many cannot insist on abstinence or the use of condoms," she says, "because of fear of emotional or physical abuse by their partners."