The evolution of HIV testing requirements in New York State, 1989-2013.

In 2010, New York State (NYS) made major changes to its HIV testing law to come more closely into compliance with 2006 recommendations of the Centers for Disease Control and Prevention. Because of the size and severity of the epidemic in NYS, the strong public health response, and powerful advocacy community, the state had early on enacted strict rules around all aspects of HIV testing. Between 2006 and 2010, 12 distinct legislative proposals were advanced to modernize NYS's approach, leading ultimately to the bill that became law and went into effect on September 10, 2010. The approved changes included oral consent for rapid HIV tests, streamlined provision of pretest information, and most notably a mandated offer of HIV testing to all persons between 13 and 64 years of age. In 2014, NYS finally removed the requirement for written informed consent (except in criminal justice settings). In a separate legislative action and in tacit acknowledgment to the success of the 2010 HIV testing law, a mandate for hepatitis C testing for persons born between 1945 and 1965 was adopted. For a variety of reasons, HIV-related statutes have sometimes been difficult to change, but once the initial inertia is overcome, additional changes may come more quickly.