Everyone in the U.S. ages 15 to 65 should be screened at least once for HIV, the virus that causes AIDS, to lower the risks of illness and death, a medical advisory group to the government recommended.
Early identification and treatment are crucial for preventing the virus’s spread and lengthening the lives of those who are infected, according to the draft guidelines released yesterday by the U.S. Preventive Services Task Force. Previously, screening focused on people in high-risk groups and pregnant women. That recommendation was made in 2005.
By increasing the number of people to be tested, the group hopes to reduce the estimated 50,000 annual new cases in the U.S. About 1.2 million people in the country are currently infected, and a fifth to a quarter of these don’t know they’re HIV-positive, according to the task force. By getting those people diagnosed, they could be treated more quickly, as well as lowering the risk they might infect anyone else.
“Not everyone who gets infected has engaged in risky behavior, but none of us ever knows for certain what our partners are doing,” Virginia Moyer, a professor of pediatrics at Baylor College of Medicine and the current task force chairwoman, said yesterday in an interview. “So it’s valuable to get tested even if you haven’t engaged in any risky behavior.”
The change in guidance stemmed from research conducted recently showing that earlier treatment of HIV makes it less likely that patients will suffer ill effects from the disease or die, Moyer said. And because the HIV test is “extremely accurate,” there are rarely false positives, she said.
“It is a huge deal,” said Carlos del Rio, a professor of global health and medicine at Emory University in Atlanta and co-director of the Emory Center for AIDS Research. “We have the highest number of new infections of any developed country. We have to do something.”
The new recommendations will allow doctors to order the HIV test for their patients without having to quiz them about sexual habits to see if they are in a high-risk group to justify the test for an insurance company, del Rio said.
“This allows me as a clinician in primary care to avoid having a risk discussion with my patients,” he said.
Those with the highest risk, which includes gay men and those who use injection drugs, should be tested every year.
The task force, based in Rockville, Maryland, is a panel of medical professionals, composed mostly of primary care providers. The draft guidelines on HIV have been posted for public comment on the group’s website. Comments may be submitted from Nov. 20 to Dec. 17.
The advice of the task force is often used by insurance companies and government programs to decide whether to pay for certain health-care procedures. The group recommended in May that prostate cancer screening be discontinued, after scientific studies showed that the number of deaths avoided by the test were “very small” compared with the risks from treatment. The panel also drew criticism in 2009 for questioning the value of breast-cancer screening in women younger than 50.
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