Surely if there was ever a virus worth getting ahead of, it's the human immunodeficiency virus (HIV).

HIV, which causes AIDS, has killed millions. It afflicts all levels of society, young and old, gay and straight. It has been a serious problem in this country for at least 20 years.

One in five people who have HIV don't even know it, according to 2006 estimates by the Centers for Disease Control and Prevention. And, the CDC points out, "the majority of new infections are transmitted by those who are unaware of their infection."

That's why it's disturbing that most U.S. hospitals and healthcare clinics don't follow government recommendations to make HIV screening more common.

The CDC says too many people — about 38 percent — hadn't been tested for HIV before developing AIDS.

A study presented at the Forum for Collaborative HIV Research summit last week showed a similar trend: In data drawn from eight health plans, of more than 10,000 people diagnosed with AIDS-related illnesses, only 5 percent received an HIV test in the previous five months.

Early detection can allow a person to take steps to avoid unknowingly spreading the virus. And early treatment, before symptoms manifest themselves, can extend the length and quality of a person's life.

The CDC has urged states to remove intimidating requirements that patients provide special written consent and counseling before taking an HIV test. Some 40 states have done so, but Hawai'i has not. It should.

Bills that attempted to address the CDC's proposals failed in the last legislative session; the Legislature should revisit the issue next year.

The goal should be to encourage more people who might be at risk to get tested.

A patient's consent must be required, but as an opt-out — unless the patient says no, the test is given.

And while an individual should have the right to pretest counseling, there's no good medical reason to require it in all cases.

HIV is too common, and its effects too serious, to treat it more gingerly than other diseases.

There are an estimated 1.1 million infected with HIV in the United States, according to the CDC.

In Hawai'i, 3,011 AIDS cases were reported between 1983 and 2007. Of those, 1,752, or 58 percent, are known to have died.

The CDC wants to bring those numbers down and has recommended every American between 13 and 64 voluntarily get an HIV test.

While that's not likely to happen, it is still critical that states do all they can to remove barriers to HIV testing. It's one of the most important tools in the battle to get ahead of this disease.