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January 21, 2009

CDC Recommendations for Opt-Out HIV Testing

JAMA. 2009;301(3):274-276. doi:10.1001/jama.2008.1008

To the Editor: I endorse the CDC recommendations for opt-out HIV testing discussed in the Special Communication by Dr Bartlett and colleagues1 and believe that all available tools to identify and counsel HIV-infected individuals should be pursued. However, one important population of persons must be considered in any such policy: those who are participants in HIV vaccine trials. By 2008, more than 30 000 individuals worldwide had participated voluntarily in experimental HIV vaccine trials.2,3 The CDC recommendations pose some complex issues for these HIV vaccine trial participants, as many will test positive in many of the antibody-based screening assays.4 In the last 5 years, almost all HIV vaccines have elicited some reactivity in commercially based assays.4 All of these vaccine study participants are HIV-negative by RNA/DNA assays.2,5

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