BALTIMORE (AP) – Testing of high-risk people is the best way to find people who don’t know they are infected with the AIDS virus, an epidemiologist at Hopkins said in an article published Friday.

Dr. David R. Holtgrave also says federal guidelines that call for routine testing of all Americans ages 13-64 for the AIDS virus might not be as effective.

Holtgrave is an epidemiologist with the Johns Hopkins Bloomberg School of Public Health. His article appears in PLoS Medicine, an online medical journal.

Under the government’s new policy, Holtgrave estimated that $864 million would be spent in one year to diagnose nearly 57,000 new infections under the government’s new policy, assuming that one percent of those tested are infected.

But 188,170 new infections could be identified for the same amount of money by focusing on drug treatment facilities, prisons and community health centers in high-risk neighborhoods. Those populations, Holtgrave wrote, have higher risk of HIV than the population as a whole and less access to regular health care.

Such targeted testing, he said, would also concentrate on patients who are known to use street drugs or engage in risky sexual behavior.

“I don’t want to make it seem that I’m anti-testing – the question is whether there are better ways to do this,” Holtgrave said.

The federal guidelines were issued in September 2006. The Centers for Disease Control and Prevention, acknowledging that universal testing could take a considerable amount of a doctor’s time, said physicians could skip counseling patients and getting their written consent before testing them for HIV.

Instead, patients would be required to opt out of testing. Doctors would also counsel patients who tested positive.

But Holtgrave said counseling before testing is necessary to tell patients about ways to protect themselves and their partners.