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Premarital Screening for HIV

James L. Nadler, MD, MPH
JAMA. 1988;259(21):3127. doi:10.1001/jama.1988.03720210017012.
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To the Editor.  —On Jan 1, 1988, Illinois and Louisiana became the first states to begin compulsory premarital screening for human immunodeficiency virus (HIV) antibodies. The following case report of an indeterminate test result demonstrates one of several serious difficulties encountered with premarital HIV testing. Equivocal results place undue emotional stress on the engaged couple and are confounded by the time constraints of the marriage license application process.

Report of a Case.  —A woman in her early 20s came to the clinic for a mandatory premarital blood test. Our clinical staff had prepared extensively to provide couples with educational material and consent forms, as well as to ensure timely, accurate, and strictly confidential test results.1A week later the results showed a repeatedly reactive enzyme-linked immunosorbent assay result (her fiancé had a negative result). Western blot assay showed an indeterminate result reactive to the p24 antigen only. She had


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