Last week the Centers for Disease Control and Prevention released new recommendations for all physicians for HIV testing. The new recommendations were generated in response to the fact that of the approximately 1 million Americans infected with HIV, about one quarter have not been tested and are unaware of their infection. These patients can not take advantage of the many therapies available for HIV infection, and may unknowingly transmit HIV to others. The CDC hopes that if all patients with HIV can be diagnosed, they can receive appropriate treatment and counseling, potentially slowing the spread of infection. They also hope that routine testing will remove any stigma associated with testing, so that those who are infected can be tested whether or not they report high-risk behaviors to their physician. You can read the CDCâ€™s questions and answers about the new recommendations for the general public here.
The recommendations include testing all patients aged 13 to 64 once during any health encounter, whether it be in an emergency department, at their private physician, or at a public clinic. After that initial screening, patients at high risk of HIV should be tested at least annually.
Persons likely to be at high risk include injection-drug users and their sex partners, persons who exchange sex for money or drugs, sex partners of HIV-infected persons, and MSM [men who have had sex with men] or heterosexual persons who themselves or whose sex partners have had more than one sex partner since their most recent HIV test.
Everyone else can be tested as frequently or as rarely as clinical judgment dictates.
So even if itâ€™s entirely inconceivable that you have HIV, the next time I draw your blood for any other reason Iâ€™ll ask you if I can add an HIV test. (Obviously, you can decline.) Iâ€™ll be happy to answer your questions about the test and what a negative or positive result means.
Iâ€™ll be very curious to see what impact these new guidelines have on the rate of new HIV infections in the next few years.