Who this is for
Everyone in the age window, and neither body asks you to disclose a risk factor first. Both are explicit that the point of screening everybody is that risk-based testing kept missing people. On how often, only CDC gives a number: at least once, as part of routine health care. USPSTF states no interval and says the evidence does not support one.
The two bodies set slightly different age windows, 15 to 65 against 13 to 64, and both say screening outside the window is appropriate for people at increased risk.
Both also recommend more frequent testing, at least annually, for people with ongoing risk: sexually active men who have sex with men; people whose sex partner is living with HIV; people who inject drugs; people exchanging sex for money or drugs; and people with new partners of unknown status. CDC suggests every three to six months may be appropriate for some.
Both recommend HIV screening in every pregnancy.
Where the recommendations diverge
- USPSTF 15 to 65
- USPSTF Not age-bounded Not age-bounded
- CDC 13 to 64
- CDC Not age-bounded Not age-bounded
The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened.
Our note: THIS TOPIC IS BEING UPDATED: the page carried a banner at fetch reading "This topic is being updated", linking to an update in progress. The 2019 statement remains the current final recommendation. USPSTF states NO interval of its own: "The USPSTF found insufficient evidence to determine appropriate or optimal time intervals or strategies for repeat HIV screening. However, repeat screening is reasonable for persons known to be at increased risk of HIV infection." The phrase "at least once" is CDC's, not USPSTF's; it appears on the USPSTF page only where it describes CDC and ACOG.
The USPSTF recommends that clinicians screen for HIV infection in all pregnant persons, including those who present in labor or at delivery whose HIV status is unknown.
Our note: No age bounds are stated for this population, so both age fields are left empty. On repeat testing in pregnancy the page says the USPSTF found no evidence on the yield of repeat prenatal screening versus one-time screening, and records that CDC and ACOG recommend a third-trimester repeat for women with risk factors or in high-incidence settings.
CDC recommends all patients between the ages of 13 and 64 be tested for HIV at least once as part of routine health care.
Our note: From CDC's HIV Nexus clinical testing guidance for health care providers, the page dated August 17, 2026. The underlying recommendation document is MMWR Recommendations and Reports 55(RR-14), September 22, 2006, whose own wording is "In all health-care settings, screening for HIV infection should be performed routinely for all patients aged 13--64 years" (the double hyphen is that report's own typography). The 2006 report adds an exception for settings where undiagnosed HIV prevalence is documented below 0.1%.
Screen patients who may have ongoing risk factors for HIV at least annually.
Our note: Same page. No ages are attached to this recommendation, so both age fields are empty. The same page notes that more frequent testing, for example every 3 to 6 months, may be beneficial for sexually active gay, bisexual and other men who have sex with men. It also asks clinicians to use an opt-out approach and to test all pregnant women as part of prenatal care.
Why they differ
The two windows differ by two years at each end, 15 to 65 against 13 to 64, and nothing in either document turns on that gap: both bodies say people outside their window should also be screened when at increased risk. The real difference is in how the test is offered.
- CDC (2006, restated on its clinician page dated August 17, 2026) frames screening as opt-out: "Patients should be informed orally or in writing that HIV testing will be performed unless they decline (opt-out screening)." It goes further: "a separate consent form for HIV testing is not recommended", and "Prevention counseling should not be required as a part of HIV screening programs in health-care settings."
- USPSTF (2019) makes no recommendation on consent mechanics at all. Its statement is about who to screen and what the test is; the delivery model is outside its remit.
CDC published its reasoning for the opt-out model in the 2006 report, and it is an implementation argument rather than a clinical one: earlier risk-based guidelines "proved difficult to implement" because screening often was not reimbursed, busy clinicians lacked time for risk assessment, and prevalence data to target settings was usually unavailable. It adds: "More patients accept recommended HIV testing when it is offered routinely to everyone, without a risk assessment."
One thing a reader should know about currency. The USPSTF page carried a banner at the time we checked saying the topic is being updated, with a link to an update in progress. The 2019 statement is still the final recommendation, but this is a page to re-check. CDC's underlying document is nearly twenty years old, 2006, though its clinician-facing page restating the same position is dated August 2026.
What the test involves
A blood draw or an oral-fluid swab, in a clinic, a pharmacy, a community site, or at home with a self-test kit. Laboratory testing runs a combined antigen and antibody immunoassay first, then a supplementary antibody differentiation test if that is reactive, then a nucleic acid test if the picture is still unclear or recent exposure is suspected. Rapid tests give a result in minutes and any reactive rapid test is confirmed by the laboratory sequence.
CDC's model is that this happens the way any other screening test happens: you are told it will be done unless you decline, and consent sits inside the general consent for medical care rather than on its own form.
If the result is abnormal
A confirmed positive result leads to antiretroviral therapy, and both bodies frame early treatment as the reason to screen. USPSTF states that early initiation of therapy reduces progression and mortality, and that when treatment leads to viral suppression, no cases of virologically linked transmission have been observed.
A negative result is a good moment to discuss prevention. If you are at ongoing risk, both bodies recommend repeat testing, at least yearly, and CDC suggests every three to six months for some people. Pre-exposure prophylaxis is the other conversation a negative result should open.
More on this screening
Frequently asked questions
I am not at risk. Why would I be tested?
Because risk-based testing does not work well enough. CDC's own report says: "A substantial number of persons, including persons with HIV infection, do not perceive themselves to be at risk for HIV or do not disclose their risks", and "More patients accept recommended HIV testing when it is offered routinely to everyone, without a risk assessment." Both bodies recommend screening everyone in their age window regardless of stated risk; CDC is the one that puts a number on it, at least once.
I am 68. Am I outside the recommendation?
Outside the routine window in both, but not outside the advice. USPSTF says older adults at increased risk of infection should also be screened. CDC's guidance is the same in substance: its window is 13 to 64, with more frequent testing recommended for anyone with ongoing risk factors, without an age cap.
Will I have to sign a separate consent form?
CDC recommends against it: consent for HIV screening should be incorporated into the general informed consent for medical care, and a separate consent form for HIV testing is not recommended. State law varies and can require more, which is why CDC also tells clinicians to know their state's HIV testing laws. USPSTF takes no position on consent mechanics.
How often should I be retested?
At least annually if you have ongoing risk factors, per CDC, and every three to six months may be beneficial for sexually active gay, bisexual and other men who have sex with men. USPSTF says the evidence does not fix an interval, and that repeat screening is reasonable for people at increased risk. If you have not been at increased risk since your last negative test, USPSTF says routine rescreening may not be necessary.