Rapid HIV test--how available should it be?

• Position: On First Reading

A new blood test for HIV-1 (the most prevalent form of the virus in the United States) and its availability to public health clinics has been under political scrutiny lately because of approval by the Food and Drug Administration (FDA).

The new test uses a single drop of blood, can be processed in 20 minutes and is simple to use.

The FDA, however, has approved the test for use only in labs that meet the requirements of the Clinical Laboratory Improvement Act. This means that public HIV testing sites, public clinics, and private physicians' offices, which typically do not have a laboratory on location that meets the law's regulations, are not able to perform this test. Public health officials believe that the test would be most useful in these settings.

Currently, about a third of the people tested in a public clinic or HIV test site never return for their results. But other groups feel that this test should be performed only by approved laboratories because of the potential lack of counseling, contact tracing, partner notification and other public health measures that aren't followed if the test is given in too casual a setting.

Concern has also been expressed about the...