Widening the Net for HIV Tests

HIV testing recommended for all adults by US task force

(RxWiki News) Many people only consider getting an HIV screening after they think there has been a risk of exposure. Times may be changing. A few health officials are saying that this way of thinking should change.

The US Preventive Services Task Force (USPSTF) is now recommending that all people between the ages of 15 and 65 years old, as well as all pregnant women, be screened for HIV.

This expansion was largely based on new evidence showing that early identification and treatment of the disease can significantly help lower the risk of the infection progressing to AIDS.

"Talk to your doctor about HIV testing."

In a statement written on behalf of the USPSTF by Virginia A. Moyer, MD, MPH, chair of the task force, the group recommends that people younger than 15 or older than 65 who have an increased risk also be screened.

These recommendations are an update from those released in 2005. At that time, the USPSTF recommended that clinicians perform HIV screenings only on pregnant women and those adolescents and adults at increased risk.

This update now recommends HIV screenings for all teens and adults between ages 15 and 65.

“Convincing evidence also shows that identification and treatment of HIV-positive pregnant women dramatically reduces rates of mother-to-child transmission,” wrote Dr. Moyer. “The overall benefits of screening for HIV infection in adolescents, adults, and pregnant women are substantial.”

Despite the benefits of early detection, the USPSTF reported that late diagnosis of HIV is common and that in 2008, 33 percent of people newly diagnosed with HIV had developed AIDS within one year.

The USPSTF estimated that 1.2 million Americans currently have HIV, but between 20 and 25 percent of people with HIV are not aware of their infection. The task force also reported that almost 600,000 people in the US have died from the disease since the first cases developed in 1981.

Dr. Moyer reported that the best way to reduce deaths from HIV is to prevent exposure to the infection, and stressed that the use of condoms “...substantially decrease[s] the risk for transmission of HIV and other STIs.”

Dr. Moyer noted that that these recommendations did not consider the cost-effectiveness of screenings. 

“For policy context, however, the USPSTF reviewed some cost-effectiveness analyses published since its previous review,” wrote Dr. Moyer. “These analyses, which include downstream costs, support the cost-effectiveness of HIV screening in settings with low or average HIV prevalence.”

In an interview with dailyRx News, Adam C. Powell, PhD, health care economist, said, "These new guidelines from the U.S. Preventive Services Task Force are likely to have a rapid and broad impact on how providers practice medicine."

"The new guidelines should save people from having to answer awkward risk assessment questions, and enable more people with undiagnosed HIV to receive early treatment," said Dr. Powell. "Making HIV testing the default will help reduce the stigma associated with testing."

The statement was published by the Annals of Internal Medicine on April 30. No conflicts of interest were reported.

Review Date: 
May 1, 2013