65242 Federal Register / Vol. 65, No. 211 / Tuesday, October 31, 2000 / Notices

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Centers for Disease Control and

Prevention

Draft Revised Guidelines for HIV

Counseling, Testing, and Referral

AGENCY: Centers for Disease Control and

Prevention (CDC), Department of Health

and Human Services (HHS).

ACTION: Notice and Request for

Comments.

SUMMARY: This notice announces the

availability for public comment of a

document entitled ‘‘Revised Guidelines

for HIV Counseling, Testing, and

Referral.’’

DATES: Comments must be submitted in

writing on or before November 30, 2000.

Comments should be submitted to the

Technical Information and

Communications Branch, Mailstop E–

49, Division of HIV/AIDS Prevention,

National Center for HIV, STD, and TB

Prevention, Centers for Disease Control

and Prevention (CDC), 1600 Clifton

Road, N.E., Atlanta, Georgia 30333; Fax:

404–639–2007; E-mail:

hivmail@cdc.gov.

FOR FURTHER INFORMATION CONTACT:

Requests for copies of the draft ‘‘Revised

Guidelines for HIV Counseling, Testing,

and Referral’’ should be submitted to

the CDC National Prevention

Information Network, P.O. Box 6003,

Rockville, Maryland 20849–6003;

telephone (800) 458–5231; or copies can

be downloaded from the Division of

HIV/AIDS Prevention website at

www.cdc.gov/hiv.

SUPPLEMENTARY INFORMATION: The first

CDC guidelines, published in 1986,

highlighted the importance of offering

voluntary testing and counseling

services and maintaining confidential

records. In 1987, CDC guidelines

emphasized the need to decrease any

barriers to counseling and testing,

especially disclosure of personal

information. An additional report was

published in 1993 to supplement and

update the 1987 guidelines. These

guidelines described the model of HIV

prevention counseling which is

currently recommended. The 1994

report, ‘‘HIV Counseling, Testing and

Referral Standards and Guidelines,’’

focused on standard testing procedures

and reiterated the importance of the HIV

prevention counseling model and the

need for confidentiality of counseling

services. The recommendations in the

current draft ‘‘Revised Guidelines for

HIV Counseling, Testing, and Referral’’

reflect new advances which have

occurred during the last 6 years in the

areas of HIV counseling, testing, and

referral: (1) High-quality HIV prevention

counseling models are efficacious for

changing behavior and reducing the

incidence of sexually transmitted

diseases (STDs) in HIV-uninfected

persons at increased risk. (2) Treatment

has been found to be effective,

improving quality and duration of life.

(3) Therapy has been shown to

dramatically reduce the risk of perinatal

HIV transmission. (4) New testing

technologies are increasingly available.

(5) Guidances on partner counseling and

referral services, prevention case

management, prevention and control of

STDs, and prevention of opportunistic

infections have been published.

Dated: October 25, 2000.

Joseph R. Carter,

Associate Director for Management and

Operations, Centers for Disease Control and

Prevention (CDC).

[FR Doc. 00–27869 Filed 10–30–00; 8:45 am]

BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND

HUMAN SERVICES

Centers for Disease Control and

Prevention

Draft Guidelines for Revised U.S.

Public Health Service

Recommendations for Human

Immunodeficiency Virus (HIV)

Screening of Pregnant Women

AGENCY: Centers for Disease Control and

Prevention (CDC), Department of Health

and Human Services (HHS).

ACTION: Notice and Request for

Comments.

SUMMARY: This notice announces the

availability for public comment of a

document entitled ‘‘Revised U.S. Public

Health Service Recommendations for

Human Immunodeficiency Virus (HIV)

Screening of Pregnant Women.’’

DATES: Comments must be submitted in

writing on or before November 30, 2000.

Comments should be submitted to the

Technical Information and

Communications Branch, Mailstop E–

49, Division of HIV/AIDS Prevention,

National Center for HIV, STD, and TB

Prevention, Centers for Disease Control

and Prevention (CDC), 1600 Clifton

Road, NE., Atlanta, Georgia 30333; Fax:

404–639–2007; E-mail:

hivmail@cdc.gov.

FOR FURTHER INFORMATION CONTACT:

Requests for copies of the draft ‘‘Revised

U.S. Public Health Service

Recommendations for Human

Immunodeficiency Virus (HIV)

Screening of Pregnant Women’’ should

be submitted to the CDC National

Prevention Information Network, P.O.

Box 6003, Rockville, Maryland 20849–

6003; telephone (800) 458–5231; or

copies can be downloaded from the

Division of HIV/AIDS Prevention

website at www.cdc.gov/hiv.

SUPPLEMENTARY INFORMATION: In 1994,

the U.S. Public Health Service (USPHS)

published guidelines for use of

zidovudine (ZDV) to reduce perinatal

HIV transmission. In 1995, the USPHS

issued guidelines recommending

universal counseling and voluntary HIV

testing of all pregnant women and

treatment for those found to be infected.

Publication of these recommendations

was followed by rapid implementation

by health care providers, widespread

acceptance of chemoprophylaxis by

HIV-infected women, and a steep and

sustained decline in perinatal HIV

transmission. Observational studies

have confirmed the effectiveness of ZDV

in reducing the risk of perinatal

transmission that has resulted in a

greater than 75% decline in pediatric

AIDS cases diagnosed in 1998. Despite

this progress, children are still

becoming infected, with 300–400 babies

being born with HIV each year in the

United States. Studies show that many

women, especially those who use illicit

drugs, are not being tested for HIV

during pregnancy because of lack of

prenatal care.

In 1998, the Institute of Medicine

(IOM) completed a study to assess the

impact of current approaches for

reducing perinatal HIV transmission,

identify barriers to further reductions,

and determine ways to overcome these

barriers. They concluded that continued

transmission is mainly due to a lack of

awareness of HIV status among some

pregnant women and that HIV testing

should be simplified and routinized.

IOM recommended that testing should

be offered to all pregnant women as part

of the standard battery of prenatal tests,

regardless of risk factors and the HIV

prevalence rates in the community.

They also recommended that women

should be informed that the HIV test is

being done and of their right to refuse

to be tested.

To address these and other issues, the

USPHS convened an expert consultation

in April 1999 and sought widespread

public comment in revising the 1995

guidelines for HIV counseling and

testing for pregnant women. The

resulting guidelines presented in the

draft ‘‘Revised U.S. Public Health

Service Recommendations for Human

Immunodeficiency Virus (HIV)

Screening of Pregnant Women’’ differ