Implementing Routine HIV Testing in Clinical Settings in Massachusetts, Massachusetts Department of Public Health, Office of HIV/AIDS (2009)

In conjunction with a clinical advisory, the Massachusetts Department of Health (MDPH) issued these guidelines to assist health care providers with implementation of routine HIV testing in health care settings. Like the clinical advisory, the subtext of the guidelines is that routine offering of HIV testing in all health care settings, consistent with the primary goal of the U.S. Centers for Disease Control and Prevention (CDC) 2006 guidelines, can be accomplished without changing current Massachusetts law, which requires documented (i.e., patient-written), informed (i.e., pre-test communication with patients) consent.

The guidelines are divided into sections covering (1) background information, (2) informed consent and minimum counseling requirements, (3) maintaining patient confidentiality, (4) models for implementation of routine testing in clinical settings, (5) connecting clients to care, and (6) tools and resources. Section 1 includes a table with a side-by-side comparison of the CDC recommendations and the MDPH recommendations, noting that in Massachusetts, written consent and pre-test counseling are required. Section 2 covers the state HIV testing law, consent for minors, contents of pre-test counseling, and recommendations for post-test counseling, regardless of the test result. Section 3 describes the various state and federal laws that mandate confidentiality of HIV test results.

Section 4 offers health care providers several different ways to implement routinely-offered testing in a clinical setting. The remaining sections of the guidelines focus on the importance of patient-centered care, ensuring that patients have access to the care and resources they need.