Symposium on antimicrobial therapyHIV Screening in the Health Care Setting: Status, Barriers, and Potential Solutions
Section snippets
HIV Testing in the United States
In 1985, when the US Food and Drug Administration approved the first tests for the detection of antibodies to HIV, the primary purpose was to screen blood donations to prevent HIV transmission from blood transfusion.6 To dissuade persons from using blood donation centers to obtain an HIV test, HIV counseling and testing programs based at “alternative testing sites” were established to provide these services. During the past 25 years, HIV testing has become more widely available and acceptable.
The Critical Role of HIV Testing in Curbing the HIV Epidemic
Testing for HIV plays a prominent role in the National HIV/AIDS Strategy released by the White House in July 2010.21 As shown in the Figure, of the estimated 1.2 million persons living with HIV in the United States, 80% are aware of their infection, 62% have been linked to HIV care, 41% stay in HIV care, 36% are receiving antiretroviral therapy, and only 28% have a suppressed viral load.19 Transmission rate modeling estimates that the 20% of persons living with HIV who are unaware of their
Barriers to Routine HIV Testing in the Health Care Setting and Potential Solutions
Health care professionals in the United States have been slow to implement the 2006 CDC recommendations for HIV screening of individuals aged 13 to 64 years. For example, only 33% of community health care personnel from Massachusetts incorporated HIV screening into their practices.33 In another study, only one-quarter of eligible patients in an emergency department were offered HIV screening,34 and less than 5% of adults seen in an emergency or urgent care setting were tested for HIV.35 These
Conclusion
The benefits of antiretroviral therapy are undisputed; it substantially reduces illness and death attributed to HIV infection. In addition, the HPTN 052 clinical trial showed that antiretroviral therapy prevents the transmission of HIV to uninfected sexual partners from HIV-infected persons receiving treatment. There is also emerging data supporting that earlier initiation of antiretroviral therapy results in improved outcomes for the individual and communities. These benefits of antiretroviral
Acknowledgments
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC.
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Cited by (37)
HIV Testing Strategies for Health Departments to End the Epidemic in the U.S.
2021, American Journal of Preventive MedicineCitation Excerpt :Public health experts and health clinic professionals have identified several areas for improvement. Rizza et al.22 described several barriers, including competing clinical priorities, laws and regulations that support opt-in rather than opt-out testing, assumptions that behavioral risk‒based screening is optimal, and third-party billing. Others23–25 have more recently suggested that coupling screenings for HIV with comprehensive care for other routine screenings, integrating screening into the normal clinical flow, being client driven, and using automated computer systems can greatly increase the uptake of healthcare screening.
How well are U.S. primary care providers assessing whether their male patients have male sex partners?
2018, Preventive MedicineCitation Excerpt :In April 2013, the United States Preventive Services Task Force (USPSTF) issued updated recommendations on routine testing for HIV (U.S. Preventive Services Task Force, 2013), which were largely consistent with the 2006 CDC HIV testing recommendations, and suggested that at least annual HIV testing for very high-risk groups, such as MSM, was a “reasonable approach”. Despite these recommendations, and several reports indicating the acceptability of routine testing among the public (Christopoulos et al., 2012; Hack et al., 2013; Harmon et al., 2014; Jover-Diaz et al., 2012; Valenti et al., 2012), universal HIV testing has not been widely implemented in healthcare settings (Centers for Disease Control and Prevention, 2012a, 2013a; Hoover et al., 2013; McNaghten et al., 2013; Rizza et al., 2012), and many MSM are still not being screened frequently enough (Centers for Disease Control and Prevention, 2016). MSM who report being offered an HIV test by their doctor are more likely to disclose male-to-male sexual activity (Wall et al., 2010).
Changing HCW attitudes: a case study of normalizing HIV service delivery in emergency departments
2022, BMC Health Services ResearchCotesting for Human Immunodeficiency Virus and Sexually Transmitted Infections in the Emergency Department
2022, Sexually Transmitted DiseasesAging Love: A Sexual Health Model for Older Adults
2022, Creative NursingHIV testing among LGBTQIA+ individuals: the impact of outness and peer openness
2022, International Journal of Adolescence and Youth
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