Two years after federal health officials recommended that everyone get tested for HIV at least once, the exam still isn’t routine.

In 2006, the Centers for Disease Control and Prevention (CDC) said that all Americans between the ages of 13 and 64 should take the test, because nearly a quarter million people in the U.S. are infected but don’t know it. Today, just 50 to 100 of the country’s 5,000 emergency rooms routinely test for the virus, which requires patient consent, according to research presented yesterday at the Forum for Collaborative HIV Research meeting in Washington.

The ER is often where AIDS patients – many of whom are poor and uninsured – end up, the Associated Press notes. But many doctors are reluctant to offer it because insurers don’t always pay for the screen, according to the Washington Post. The test costs between $15 and $120.

"With HIV, ignorance is not bliss. Those who are unaware of their infection cannot seek treatment, and are at least three times more likely to transmit the virus," Veronica Miller, the forum’s director, said in a statement. "Two years after the CDC recommended routine testing, initial successes show its potentially powerful impact, but major barriers keep it from being the national norm."

Studies at the forum show that Washington, D.C., and some cities, such as New York and Oakland, Calif., have boosted testing rates. One program in New York City jails increased testing from 6,500 to 25,000 inmates between 2004 and 2006, according to a press release summarizing the research.

But  other research indicates that the test isn’t yet the norm: Insurance claims show that just over a third of people getting treated for sexually transmitted diseases get an HIV test, and that up to 41 percent of pregnant women aren’t tested either, even though the CDC recommends routine testing of pregnant women to prevent transmission to their babies.

More than 1.1. million Americans have HIV, which causes AIDS.

Image by iStockphoto/Steve Goodwin