HIV

HIV (human immunodeficiency virus) attacks the body’s immune system by destroying cells that fight disease and infection. An estimated 1.1 million US adults and adolescents were living with HIV in 2005. Of those infected, an estimated 15% were unaware they were infected. HIV testing laws and laboratory reporting laws support HIV prevention and care. Many states also have laws that make it a crime to knowingly expose an individual to HIV.

State Testing Laws

Laws regarding routine testing help people in the United States know their HIV status. Testing at routine healthcare visits gives physicians a chance to detect infections or disease in people who may not appear at risk.

• States with HIV Testing Laws
  Forty-nine states and DC currently have laws that are consistent with CDC recommendations on HIV testing.
• Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings (2006)
  Healthcare providers should not require a separate written consent form to test for HIV. Telling patients that they will be tested for HIV counts as informed consent. Patients may  opt out of testing.
• State Adolescent Consent Laws and Implication for HIV Pre-Exposure Prophylaxis (PrEP)[PDF – 357KB]
  This article examines minors’ ability under different state laws to consent to medical care, including HIV testing and treatment, and analyzes how different state laws affect their access to PrEP.

State Laboratory Reporting Laws

The amount of HIV in a person’s blood is called “viral load.” HIV attacks the CD4 white blood cell. Viral load and CD4 cell count test results can indicate whether an HIV treatment is working.

• State Laboratory Reporting Laws: Viral Load and CD4 Requirements
  Every state has laws or regulations on laboratory reporting, but not all laws require laboratories to report all CD4 and viral load test results. Forty-two states and DC require laboratories to report all levels of CD4 and viral loads of all HIV-positive individuals to their HIV surveillance programs.
• Dear Colleague Letter from Division of HIV/AIDS Prevention, CDC, to HIV Surveillance Coordinators, AIDS Directors, State Epidemiologists, State Health Officers, and State Public Health Lab Directors[PDF – 135KB] (2013)
  This letter from CDC emphasizes the importance of CD4 and viral load reporting.

Criminal Laws

Many states have HIV-specific criminal laws. These laws impose criminal penalties on people who know they have HIV and consciously expose others to it without informing them first.

• Prevalence and Public Health Implications of State Laws That Criminalize Potential HIV Exposure in the United States (2014)
  This article analyzes the prevalence and characteristics of HIV-specific criminal laws in the 50 states and DC.
• United States Department of Justice Civil Rights Division Best Practices Guide to Reform HIV-Specific Criminal Laws to Align with Scientifically Supported Factors[PDF – 333KB](2014)
  This article provides technical assistance to states for re-examining their HIV-specific criminal laws to ensure that policies reflect contemporary understanding of HIV transmission routes and associated benefits of treatment.
• National HIV/AIDS Strategy for the United States: Updated to 2020
  This report released by the White House provides guidance on HIV-specific criminal law.

For more information about HIV, visit CDC’s HIV/AIDS website.