New Centers for Disease Control and Prevention's guidelines on HIV counseling and testing for the general population and pregnant women.

We review two new HIV counseling and testing guidelines by the U.S. Centers for Disease Control and Prevention. The guidelines, which address the general population and pregnant women, reflect an important shift in the goals and methods of counseling and testing that has widespread implications. The guidelines' defining characteristic is the greater emphasis on increasing the numbers of people knowing their HIV status while maintaining the historical focus on extensive pretest counseling and consent procedures. We discuss the policy and practice implications by evaluating five factors: 1) Will the guidelines be adopted? 2) Will at-risk and infected individuals be identified for counseling and testing? 3) Will health care providers offer counseling and testing and patients accept counseling and testing, obtain their test results, seek treatment, and change risky behaviors? 4) Will the guidelines be relatively cost-effective? 5) Will the guidelines be compatible with ethical standards?