April 30, 2013
The US Preventive Services Task Force (USPSTF) guidelines now recommend routine voluntary HIV screening for every US resident ages 1565 because people respond best to treatment early in an infection. This is also the time when people are often asymptomatic, so the only way to detect an HIV infection is through testing. The updated USPSTF recommendations now align with CDC, the American College of Physicians, the Infectious Disease Society of American, and the American College of Obstetricians and Gynecologists guidelines.
The 2013 USPSTF guidelines recommend one-time HIV screening for everyone ages 1565; HIV testing for pregnant women; and annual HIV screening for high-risk groups. High-risk groups include men who have sex with men; people who have unprotected vaginal or anal sex; and those who have sex with a partner who is HIV-infected, bisexual, an injection drug user, or who exchanges sex for money. Patients also should have the option to ask questions and decline testing.
Previous USPSTF guidelines -- issued in 2005 -- recommended HIV screening for pregnant women and high-risk groups, but stopped short of universal screening because of the possibility of false-positive results, social stigma from having HIV, and possible long-term risk of cardiovascular disease resulting from antiretroviral treatment (ART). The USPSTF panel has decided that the benefits of screening outweigh any risks, since 25 percent of US residents who have HIV are unaware of their infection. Also, recent studies indicate the increased risk of cardiovascular disease is slight.
University of California at San Francisco AIDS experts Dr. Moupali Das and Dr. Paul Volberding stated that only effective HIV screening and successful ART can make ending the epidemic "remotely possible."
The full report, "Screening for HIV" was published online by USPSTF at www.uspreventiveservicestaskforce.org/uspstf/uspshivi.htm.