The AIDS Institute Applauds Routine HIV Testing Recommendation
USPSTF Grade Change Will Increase Access to HIV Care and Decrease New Infections
November 19, 2012
Washington, D.C. -- The U.S. Preventive Services Task Force (USPSTF) issued a draft recommendation today in strong support of routine HIV testing for ALL adolescents and adults ages 15 through 65. Until now, the Task Force recommended testing only for people who are at risk for HIV and pregnant women. "This marks a monumental shift in how HIV in the United States can be prevented, diagnosed and treated," commented Carl Schmid, Deputy Executive Director of The AIDS Institute.
"Today's announcement will also favorably impact the reimbursement of HIV testing across payers which removes one of the barriers to HIV testing," added Lew Sibert, Treasurer of The AIDS Institute.
Grades issued by the USPSTF often are the basis for payers to cover preventive services. This is even more significant under the Affordable Care Act (ACA), which bases reimbursement for preventive services by private insurers, Medicare and Medicaid on USPSTF grades. For example, under ACA, private insurers must cover all Grade A and B USPSTF services without cost-sharing. The USPSTF has recommended that routine HIV screening now be given an "A," a change from its current "C" grade.
Upon implementation of this recommended grade change, all payers, including Medicaid and Medicare, will be required or incentivized to cover routine HIV screening.
Risk-based HIV testing has been an ineffective screening strategy. In 2006, the Centers for Disease Control and Prevention (CDC) recommended routine testing for anyone between the ages of 13 and 64. This USPSTF recommendation is now more in line with that of the CDC.
Almost one in five people living with HIV in the U.S. -- over 200,000 individuals -- continue to be unaware of their HIV status. Additionally, there are 50,000 new infections each year. Testing people early and linking them to care and treatment is critical not only for their own health outcomes but also in preventing new infections.
Early awareness of HIV status is important because when someone knows they are HIV-positive, they can take steps to prevent transmission of the virus. Over half of all new infections are attributable to someone who is not aware of their infection. Currently, 40 percent of people diagnosed with HIV progress to full blown AIDS within one year of their diagnosis, meaning that they have carried the virus for many years without detection.
Testing is the only way to learn of one's HIV status and when an individual tests positive, they can be linked to care and treatment, which helps prevent the spread of HIV. A recent study has shown that individuals on continuous antiretroviral treatment can reduce the amount of virus in their body to such a low level that the risk of transmission is reduced by 96 percent.
Today's announcement is a draft and subject to a 30-day public comment period. The USPSTF also reaffirmed its "A" grade for pregnant women, and propose testing for adolescents under 15 and adults over 65 who are at increased risk of HIV.
"While this is a significant step forward, we are cognizant that a USPSTF positive recommendation is only one step in facilitating increased access to HIV screening," remarked Schmid. "Changing the grade for HIV testing will go a long way towards improving access to HIV screening. However, providers still must offer the test and patients must be willing to take it."
The U.S. Preventive Services Task Force (USPSTF) is an independent group of experts supported by the Agency for Healthcare Research and Quality (AHRQ), an agency of the U.S. Department of Health and Human Services. The panel is charged with making evidence-based recommendations regarding clinical preventive services.
This article was provided by The AIDS Institute. Visit The AIDS Institute's web site to find out more about their activities and publications.
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