The United States should have a national HIV/AIDS strategy, developed through the White House Office of National AIDS Policy and relevant stakeholder groups, declared a resolution passed at the recent 158th annual American Medical Association (AMA) meeting in Chicago.

"Still, 25 percent of patients with HIV don't know their status, and 50 percent present late for care," said Baligh Yehia, MD, an internist from Baltimore and an alternate delegate for the American College of Physicians. "We still have not been able to impact the incidence and prevalence for this disease. It's time to focus on the crisis in our own backyard."

"We need a single national plan," said Joseph P. Annis, MD, AMA secretary. "We ask states to have state plans. Countries receiving aid have to have a single national plan. Why don't we have the same thing?"

Delegates debated whether to support states that mandate HIV screening for women in labor who had not been tested earlier during their pregnancy. Another proposed resolution would urge medical societies to lobby in favor of such mandates.

"We don't support mandatory testing," said Carol Berkowitz, MD, an American Academy of Pediatrics delegate from California. "Mandates don't guarantee that the mother will accept treatment. We have got to have a more thoughtful approach."

"There are a lot of people at risk for STDs who don't perceive they are at risk," said Sally Trippel, MD, an internist and delegate for the Minnesota Medical Association. Screening could identify women with undiagnosed HIV so steps could be taken to reduce the risk of mother-to-child HIV transmission.

Delegates voted to refer both issues for additional study.