In 2006, the Centers for Disease Control and Prevention (CDC) recommended that everyone ages 13 through 64 be routinely tested for HIV. Though the desire to encourage people to know their status has been widely supported, it has also raised concerns about abandoning written informed consent and counseling—and about the government’s ability to handle newly discovered infections.

A recent study in the online medical journal PLoS ONE further complicated the CDC’s plan—it found that many states have laws limiting routine testing. Some states require that certain topics be discussed with patients before testing; others still require written consent. “The CDC is a national presence in terms of public health policy,” the study’s lead author, Leslie Wolf, an associate professor at Georgia State University College of Law, told POZ. “But these testing policies are decided on a state-by-state basis.” The CDC says some states are aligning laws with the recommendations. (California removed its written consent stipulation after the PLoS ONE article was published.) Still, Wolf warns that discrepancies between state laws and the CDC might cause testing sites to unintentionally violate those laws.