Updated Testing Protocol for Detecting Human Immunodeficiency Virus

Hugh McDonald SECRETARY OF COMMERCE AID t71,, 4"'" * * Bulletin No. 15-2025 To: Jimmy Harris COMMISSIONER, ARKANSAS INSURANCE DEPARTMENT All Licensed Life Insurers, Accident and Health Insurers, Fraternal Benefit Societies, Health Maintenance Organizations, Hospital Medical Service Corporations, and Other Interested Parties From: Arkansas Insurance Department Date: November 10, 2025 Re: Updated Testing Protocol for Detecting Human Immunodeficiency Virus The Department issues this Bulletin pursuant to 23 CAR § 101, Standards to Prevent Unfair Discrimination in Reference to the Human Immunodeficiency Virus ("HIV"), which describes how an insurer may test a proposed insured for the presence of HIV in a nondiscriminatory manner. The Department's current rule at 23 CAR § 101-103(a)(2)(B)(iii) requires an insurer to use a Western blot test to confirm HIV when two HIV enzyme-linked immunosorbent assay tests demonstrate the presence of HIV antibodies. The Centers for Disease Control no longer recommends using the Western blot, because other tests provide earlier detection of HIV and the Western blot test may produce false-negative or indeterminate results.1 The Centers for Disease Control recommends the testing protocol below2 for HIV testing: 1. Initial screening with a 4th generation HIV-1/2 antigen/antibody immunoassay; 2. If the initial screening is reactive, follow using supplemental testing with an HIV- 1/HIV-2 antibody differentiation immunoassay; and 3. If supplemental testing produces results that are negative or indeterminate, test with an HIV-1 nucleic acid test ("NAT"). 1 https://stacks.cdc.gov/view/cdc/23447 2https://stacks.cdc.goy/view/cdc/ 50872 Arkansas Department of Commerce Arkansas Insurance Department Commerce Way, Suite 102 ' Little Rock, AR 72202 INSURANCE.ARKANSAS.GOV In accordance with 23 CAR § 101-103(b)(1)-(2)3, the Insurance Commissioner prescribes the testing protocol recommended by the Centers for Disease Control as a protocol that may be used by insurance companies to test for HIV. Please direct all inquiries questions related to this Bulletin to AID's Legal Division at (501) 371-2820 or email insurance.legal©arkansas.gov. A y ns is nsurance Commissioner Date 3 In accordance with Ark. Code Ann. § 23 CAR § 101-103(b)(2), the Department obtained confirmation from the Secretary of the Arkansas Department of Health that this protocol is acceptable for HIV testing.