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to Section One | to Arts & Entertainment
posted Friday, May 3, 2013 - Volume 41 Issue 18
Feds say 'Get tested!' - Task force recommends universal HIV testing ?for ages 15 to 65
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Feds say 'Get tested!' - Task force recommends universal HIV testing ?for ages 15 to 65

by Mike Andrew - SGN Staff Writer

Everyone 15 to 65 should get at least one HIV screening, the U.S. Preventive Services Task Force said this week. Individuals outside that age range who are in high-risk groups should get tested as well.

Women should be tested during each pregnancy, the task force added.

The task force recommended at least annual screenings for people in known risk groups.

'The question is, 'Do you have ongoing risk, like new sexual partners?' Dr. Doug Owens, a task force member and professor of medicine at Stanford University said. 'If you do, then it makes sense to screen periodically.'

The CDC also says that people with risk factors including multiple sex partners, IV drug use, and men having sex with men get tested at least once a year, and perhaps more.

Patients should also be offered the opportunity to ask questions and to decline testing, the task force said.

OTHER EXPERTS AGREE
The task force's April 29 announcement, published in the Annals of Internal Medicine, is a departure from the more cautious recommendation it made in 2005. It brings the task force into line with the CDC, the American College of Physicians, the Infectious Disease Society of America, and the American Congress of Obstetricians and Gynecologists, all of which have recommended universal HIV testing.

'HIV is a critical public health problem, and there are still 50,000 new infections per year,' Owens said.

'There's very good evidence that treatment is effective when given earlier, at a time when people are often asymptomatic. So the only way they would know that they had HIV, or that they needed treatment, is to be screened.'

Recent estimates say that as many as 25% of people who are HIV-positive do not know it. The percentage is said to be much higher - up to 60% - among teens and young adults.

Until now, the task force had recommended HIV screening only for people in high-risk groups: intravenous drug users, men who have sex with men, people who have unprotected vaginal or anal intercourse, and those who have sex with a partner who is HIV-positive, Bisexual, an injection drug user, or engaged in the sex trade.

WORTH THE RISK
When formulating their earlier guidelines, task force members worried that universal testing might result in false-positive results or cause depression and social stigma among those who learned they were infected. Panel members also said that long-term treatment could result in harmful side effects, such as cardiovascular disease.

Based on more recent data, the task force 'found convincing evidence that conventional and rapid HIV antibody tests are highly accurate in diagnosing HIV infection,' wrote Dr. Virginia Moyer, a pediatrician and task force chairwoman.

'Although long-term use of certain antiretroviral drugs may be associated with increased risk for cardiovascular and other adverse events, the magnitude of risk seems to be small.'

In an editorial that accompanied the recommendation, U.C. San Francisco AIDS experts Dr. Moupali Das and Dr. Paul Volberding wrote that the new task force guidelines were of 'critical significance' and that diagnosing those who have HIV but don't realize it would have a far-reaching effect.

'Ending the epidemic will be very difficult, and only effective screening can make it remotely possible,' they wrote. 'Informing all infected persons of their status may well reduce ongoing transmission risk behavior in [and] of itself, and if antiretroviral therapy is also accepted and successful, further spread will be substantially reduced and perhaps even eliminated.'

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