Advisory panel moves to make HIV testing routine (US)

A nurse arranges test tubes containing blood taken during a free HIV test, at an HIV/AIDS awareness rally on World AIDS Day in San Salvador (Luis Galdamez, Reuters)

An influential U.S. panel has called for routine HIV screening for all Americans aged 15 to 65, a change that could help reduce some of the stigma about getting tested for the sexually transmitted infection that causes AIDS. The draft recommendations, released on Monday by the U.S. Preventive Services Task Force, a government-backed group of doctors and scientists, also called for routine HIV testing for all pregnant women. "The prior recommendations were for screening high-risk adults and adolescents," said task force member Dr Douglas Owens who is a medical professor at Stanford University. "The current recommendation is for screening everyone, regardless of their risk," said Owens, who is also affiliated with the Veterans Affairs Palo Alto Health Care System in California.

Nearly 1.2 million people in the United States are infected with HIV, yet 20 to 25 percent of them do not know it. "This marks a monumental shift in how HIV in the United States can be prevented, diagnosed and treated," said Carl Schmid, deputy executive director of The AIDS Institute, an AIDS advocacy group. The new guidelines by the task force are expected to affect the reimbursement of HIV testing, removing one of the barriers to the tests, Schmid's group said in a statement.

Under the Affordable Care Act, insurers are required to cover preventive services that are recommended by the task force. The change brings the group more in line with the U.S. Centers for Disease Control and Prevention, which in 2006 recommended HIV testing for everyone between 13 and 64. The recommendations, which had been expected, are based on the latest evidence showing the benefits of early HIV testing and treatment. Recent studies have shown that HIV treatment can reduce transmission of the virus to an uninfected partner by as much as 96 percent. "Treatment has two benefits. One is to the person who has HIV, and also treatment helps prevent transmission and protects a person's partner," Owens said.

Dr. Jeffrey Lennox, a professor of medicine at Emory University School of Medicine and chief of infectious disease at Grady Memorial Hospital, an inner-city hospital in Atlanta, said under the current recommendations, many doctors simply fail to offer the tests. "In our practice, we see patients every week who are newly diagnosed with HIV - people who have seen many physicians in the past 10 years and none of them had ever offered testing," Lennox said.

Many of these patients have far advanced disease that could have been caught earlier and successfully treated. Owens said he hopes the change will make it easier for doctors to offer testing. "You are offering this to adolescents and adults and everyone. The conversation you have with people is likely to be easier," he said. The draft recommendations are based on a study of the most recent evidence on the risks and benefits of HIV testing published in the Annals of Internal Medicine. The guidelines will be available for a 30-day public comment period before final recommendations are released, likely sometime next year.

Source: Chicago Tribune 

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