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U.S. Panel Recommends Universal HIV Testing

December 13, 2013

Originally published May 13, 2013

Every person between the ages of 15 and 65 should be tested for HIV, regardless of their levels of risk for contracting the virus, a major government-backed panel of U.S. doctors and scientists said. The move aims to improve early detection of the virus and combat stigma associated with the test.

The U.S. Preventive Services Task Force (USPSTF) made the recommendation April 29, revising its previous position that only people at high risk for contracting the virus should be tested. The panel noted that HIV testing should be voluntary and performed only with a patient's consent. It also recommended screening all pregnant women for the virus and repeat testing for any individuals at higher risk of infection.

The USPSTF's recommendations are not binding, but doctors usually heed its advice and its positions are often adopted by medical groups. According to a report from Reuters, the panel's recommendation will likely change how the test is prescribed by doctors, some of whom have not been offering the test to all of their adult patients.

"Now, everybody agrees it should be done," Jeffrey Lennox, a professor of medicine at Emory University School of Medicine and chief of infectious disease at Grady Memorial Hospital, told Reuters.

Ultimately, doctors and public health practitioners are hoping that a call for universal testing would help to erase public stigma associated with HIV testing. Patrick O'Neal, M.D., director of health protection for the Georgia Department of Public Health (DPH), said universal HIV testing would be a good step toward accomplishing that goal.

"Universal HIV testing would be the beginning of changing the mindset about the test and HIV," he said. "Identifying individuals who are HIV-positive is critical to stopping the spread of the disease."

The U.S. Centers for Disease Control and Prevention (CDC), which for many years has recommended universal HIV testing, estimate that about 18 percent of the 1.1 million Americans living with HIV do not know they are infected. O'Neal said that in Georgia, that number is about 20 percent.

Notifying a person of their HIV status is a necessary first step for directing them to health care, which can extend life and dramatically reduce the risk of transmission of the virus. When an HIV-positive person takes antiretroviral drugs, the chance they will transmit the virus plunges by 96 percent, according to the National Institutes of Health.

The panel's endorsement of universal HIV screening will also likely change how HIV testing is paid for by insurance companies, according to the Reuters report. Currently, the Affordable Care Act recommends coverage of HIV testing for adolescents and adults at high-risk of infection -- for example, men who have sex with men, illicit drug users or other people in groups with a high risk of the disease. But the law also mandates that insurers cover any screening recommended by the USPSTF.

But O'Neal said making universal HIV testing a reality is not as simple as it may sound.

"We're talking about a huge volume of tests being done," which would require additional resources and personnel, O'Neal said. "It would also take a willing public, which may be more difficult to come by than the resources."