The US Preventive Services Task Force announced today that nearly all adolescents and adults in the United States should be screened for HIV infection. This final recommendation was based upon a review of current research on HIV screening as well as considering the information provided by community members during a period of public comment.
The first recommendation states: “Everyone aged 15 to 65 should be screened for HIV infection. Teens younger than age 15 and adults older the 65 also should be screened if they are at increased risk for HIV infection.” The second recommendation states: “All pregnant women, including women in labor who do not know their HIV status, should be screened for HIV infection.”
Both recommendations come with a Grade A by the USPSTF, which means that the Task Force found strong evidence that the benefits from routinely testing for HIV greatly outweigh the risks from knowing one’s status. Essentially these recommendations encourage all clinicians in the US to test these populations for HIV.
The USPSTF found strong evidence showing that conventional and rapid HIV tests are highly accurate. They also found that starting HIV treatment is associated with a lower risk for AIDS-related illnesses and death (more convincing evidence at lower CD4 counts and adequate evidence at higher CD4 counts). Other evidence shows how testing and early treatment can prevent the further transmission of HIV to newborns, sex partners and people who share drug equipment.
As for the harms that the USPSTF noted, they found convincing evidence that although HIV meds are associated with short-term side effects, these are normally short-lived, tolerable and/or alterable. They also stated that although long-term use of HIV drugs may be associated with a higher risk for heart and other disease, the magnitude of these risks appear to be small. The overall harms from screening also appear to be small.
These broad recommendations to routinely test nearly all American adolescents and adults are a significant attempt to influence clinicians in helping identify nearly 300,000 Americans with HIV who don’t know they have the virus. In doing so, great strides can be made in reducing the transmission of HIV and bringing about the end of epidemic in the US.
Read shortened version of the Recommendations.
Read full version of Recommendations.