COMMENTS AND RESPONSES Screening for HIV TO THE EDITOR: The U.S. Preventive Services Task Force

(USPSTF) recently published updated guidelines for HIV screening (1). In preparing these guidelines, the USPSTF reviewed studies that demonstrated how routinely offering HIV testing, as opposed to offering testing only when HIV risk is identified, is cost-effective and increases the number of persons who receive HIV diagnoses (2–4). Despite this, the USPSTF, along with the Centers for Disease Con-trol and Prevention, the American College of Physicians, the Infec-tious Diseases Society of America, and other health care organiza-tions, have failed to expand recommendations for routine testing. The updated USPSTF guidelines, similar to guidelines published over the past decade, recommend routine testing only for persons identified as high-risk candidates, those residing in areas with in-creased prevalence of HIV infection (1%), and all pregnant women. Unfortunately, this strategy has failed to reduce the propor-tion of persons with undiagnosed HIV infection in this country—