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to Section One | to Arts & Entertainment
posted Friday, November 23, 2012 - Volume 40 Issue 47
Everybody in, nobody out
Section One
ALL STORIES
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Everybody in, nobody out

U.S. task force recommends HIV testing for all

by Mike Andrew - SGN Staff Writer

All Americans aged 15 to 64 should get routine HIV tests, according to a U.S. Preventive Services Task Force report released November 19.

The new draft guidelines are in line with CDC recommendations first made in 2006 that all people get tested for HIV, not just those considered at high risk. The draft will be open for public comment through Dec. 17.

If finalized, the task force guidelines could extend the number of people eligible for an HIV screening without a co-pay at their doctor's office, as part of the free preventive care provided by the Obama administration's Affordable Care Act. Under current guidelines, only people at increased risk for HIV - including Gay and Bisexual men and intravenous drug users - are eligible for free screening.

The new draft guidelines would also simplify procedures for doctors and patients. Patients having blood drawn for other exams could simply add HIV to the list, with no extra needles or swabs needed. Modern testing can cost less than $20 and require just rubbing a swab over the gums, with results ready in as little as 20 minutes. Last summer, the government approved a do-it-yourself at-home version, which sells for about $40 at drugstores.

REMOVING THE STIGMA
The proposed guidelines should also reduce any potential stigma attached to HIV testing, task force members said.

'It allows you to say, 'This is a recommended test that we believe everybody should have. We're not singling you out in any way,' said task force member Dr. Douglas Owens, a professor of medicine at Stanford University and senior investigator for the VA's Palo Alto Health Care System.

The task force proposal also recommends:

o Testing people older than 64 and younger than 15 if they are at increased risk of HIV infection,

o Testing people at very high risk for HIV infection at least annually,

o Re-testing people at somewhat increased risk every three to five years, and

o Testing women during each pregnancy, something the task force has long recommended.

We are not doing as well in America with HIV testing as we would like,' Dr. Jonathan Mermin, CDC's HIV prevention chief, said November 19.

Of the more than 1.1 million Americans living with HIV, nearly one in five - almost 240,000 people - don't know their HIV status. Most of the 50,000 new HIV infections in the U.S. every year are among Gay and Bisexual men, followed by heterosexual black women.

MOST ADULTS UNTESTED
The CDC recommends at least one routine test for everyone aged 13 to 64, starting two years younger than the task force recommended. CDC data suggests fewer than half of adults under 65 have been tested.

But even though nearly three-fourths of Gay and Bisexual men with undiagnosed HIV had visited some sort of health provider in the previous year, 48% weren't tested for HIV, a recent CDC survey found. Emergency rooms are considered a good spot to catch the undiagnosed, after their illnesses and injuries have been treated, but Mermin said only about 2% of ER patients known to be at increased risk were tested while there.

'It can sometimes be awkward to ask your doctor for an HIV test,' Mermin said, which is why making it routine during any health care encounter might help increase the rate of testing.

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