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May 27, 1988

The Use of HIV Antibody Testing by Physicians-Reply

Author Affiliations

St Paul—Ramsey Medical Center University of Minnesota Medical School

St Paul—Ramsey Medical Center University of Minnesota Medical School

JAMA. 1988;259(20):2994-2995. doi:10.1001/jama.1988.03720200016011

In Reply.  —The letter by Dr Decker illustrates the complexity of the issues related to clinical HIV testing. We do not believe that the example he cites warrants HIV testing without consent or counseling. In Minnesota, a low-incidence area for HIV infection, the chance of a transfusion recipient receiving an HIV-infected unit of blood from 1980 to 1984 was estimated to be 1:16 000. A history of blood transfusion from an area with a high incidence of HIV infection would carry a greater risk. In addition, an elderly person could be at risk from sexual exposure. Through January 1988 in Minnesota, 38 of the HIV-seropositive persons (6%) reported to the Minnesota Department of Health have been aged 50 years or older. Twenty of those persons (53%) acquired their HIV infections via male-to-male sexual contact.If an HIV test was ordered without permission, the patient's hospital bill would probably list a