When Samuel Fitzer went to the doctor a few weeks ago, the doctor recommended that the 22-year-old civil engineering sophomore be tested for HIV. He agreed to go through with the test.

“It went pretty smoothly,” Fitzer said.

Although it may have been simple for him, the Center for Disease Control and Prevention’s new recommendations for HIV testing is anything but simple for SF State Student Health Services.

According to the Center for Disease Control and Prevention’s Web site, the CDC now recommends that patients in all health-care settings be notified that an HIV test will be performed unless the patient declines, which is called opt-out screening.

The CDC no longer only considers gay males to be at a high risk for HIV. The new guidelines recommend routine testing to begin with children as young as 13 years old and annual testing for anyone who has had more than one sexual partner since his or her last screening.

Dr. Alastair Smith, director of the SF State SHS, said changing the definition of people at a high risk for HIV hugely increases the number of people in that category.

The CDC estimated that more than a quarter of a million Americans are infected with HIV but don’t know it. By implementing routine screening, people who come back positive can start effective treatment earlier, adopt behaviors to reduce HIV transmission and reduce the stigma associated with the test.

“I must admit I was surprised the CDC made such a radical change,” Dr. Smith said. “The CDC wants to try to de-stigmatize HIV and turn it into a test like any other test.”

In addition, the CDC recommended separate written consent forms and prevention and pretest counseling should not be required so it would be easier to give the test.

“We look at an HIV test as an educational experience,” Albert Angelo, health educator at SHS who gives pretest counseling to students, said. “HIV is a behavior infection. If you’re doing something to cause you to come in for an HIV test, some behavior is a concern.”

Beyond the concern of pretest counseling, the SF State SHS is still in the midst of deciding how to implement these new recommendations from the CDC.

Angelo said SHS is aware that these guidelines are new and encouraged by the CDC, but the SHS doesn’t want to make HIV testing the focus of students’ appointments if they came in for another health issue.

“The SHS wants to follow those recommendations, but we also want to make sure we’re following good medical practices,” Angelo said. “We don’t want to take away a service in place of a test.”

Another question is how to carry out the CDC’s recommendations in a way that meets cost effectiveness.

“Will the San Francisco Public Health Department increase funding? Will Family PACT fund it?” Dr. Smith said.

Family PACT, which provides reproductive health care for low-income California residents at no cost, covers HIV testing for people at a high risk. But Dr. Smith doesn’t know whether Family PACT will define high risk the same way CDC does.

“The challenge is how we efficiently and effectively start up a screening program on such a large population,” Dr. Smith said. “Effectively screening 30,000 students is a logistical nightmare.”

Angelo added that if people are not going in for regular health care, they’re not going in for routine HIV screenings.

“Screening can help, but it’s not going to be 100% effective,” Angelo said.