HIV testing protocols

THE PENNSYLVANIA CONFIDENTIALITY OF HIV-RELATED INFORMATION ACT (Act 148), as amended

In 1988, the Pennsylvania legislature passed the Confidentiality of HIV-Related Information Act, (otherwise known as Act 148) to prevent unauthorized HIV testing and disclosure of HIV-related information without the individual’s consent.  In 2006, the Centers for Disease Control and Prevention (CDC) issued HIV testing recommendations designed to increase testing. Not all of the recommendations were permissible under Pennsylvania law.  In July 2011, Act 148 was amended to allow the CDC recommendations to be legally implemented in Pennsylvania.

To see a side-by-side “before and after” comparison, click here.

The amendments, which affect only the Consent to Testing section, include new provisions and revisions to the original law.

•           A health care provider may now offer opt-out HIV testing, which means the  subject would be informed that the an HIV test will be performed, unless it is specifically refused.

•           Informed written consent has been replaced by informed documented consent. The health care providers must document that pre-test information was provided, and that the subject gave informed consent or declined the offer of HIV testing.

•           The requirement for the pretest counseling was removed, but consent shall still be preceded by an explanation of the test, including its purpose, potential uses, limitations and the meaning of its results.

•           Negative test results need not be given in person (face-to-face).

Resources/Glossary:

Confidentiality of HIV-Related Information Act (commonly known as Act 148):  This law describes Pennsylvania’s HIV testing protocol, which includes pre-test and post-test counseling. Act 148 also prohibits testing without the individual’s informed written consent, except in limited instances. (This is the old version of the law.)

Streamlined HIV testing under Act 148 (February 2011)

Fundamental Principles for HIV Testing (August 2008)

AIDS Law Project testimony before the Pennsylvania Senate Committee on Public Health and Welfare opposing Senate Bill 1261. (May 14, 2008)

Centers for Disease Control and Prevention (CDC) 2006 revised recommendations for HIV testing of adults, adolescents and pregnant women in health-care settings. (September 2006)

AIDS Law Project’s response to CDC HIV Testing  Recommendations (September 2006)

For additional information on Amendments to Act 148, please visit AIDS Law Project founder and of counsel, David W. Webber’s AIDS and the Law website using the
following link:

Commentary on Amendments to Act 148


[1]     35 Pa.C.S.A. Sec. 7601, et seq.

Pennsylvania’s HIV testing law, known as Act 148 contains clear requirements for HIV testing– pre-testing counseling, written informed consent and face-to-face post-test counseling.  Written consent can be included in a general consent for medical treatment, if the consent for testing is clear and explicit. Prior to testing, information about the test can be provided in writing – in many cases, actual counseling of patients is not necessary. When giving results to patients, providers must offer routine information and referrals, consistent with sound medical practices that are already widely utilized.

HIV testing is voluntary, except in very limited situations, such as military recruits’ entrance exams and inmates in federal prisons.

An insurance company may require HIV testing before issuing a policy. Before the insurer can perform an HIV test, it must tell an applicant what the test means, other options for HIV testing and how the test will affect an application for insurance (as typically, the application will be denied).

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