Health officials in Massachusetts are resisting the national momentum toward routine HIV testing, recommended last fall by the US Centers for Disease Control and Prevention (CDC). The CDC’s push for widespread, routine testing without written consent is aimed to combat stigma surrounding the disease. The CDC says the general consent that patients give for other medical screenings should cover the AIDS test as well. Massachusetts is one of 10 states that still require written consent before an HIV test is administered, The Boston Globe reports.

Public health authorities in Massachusetts agree with the CDC’s vision of routine testing for AIDS, but suggest that they can accomplish a similar goal without lifting the written consent rule by conducting an additional 11,300 HIV tests in family planning clinics, substance abuse treatment facilities and community health centers over the next two years.

The state’s decision to keep written consent in place could have a financial impact. If Massachusetts’ approach means it takes longer for the state to diagnose new cases of HIV than other states, it could cost the state federal dollars.