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ACP Urges Routine HIV Screening For All Patients

Posted by Chrissie Cole
Tuesday, December 02, 2008 12:33 PM EST
Category: Major Medical
Tags: AIDS, HIV, Antiviral Drugs, FDA and Prescription Drugs, Drug Products, AIDS Awareness


IMAGE SOURCE:© iStockPhoto / AIDS Awareness / author: MentalArt

All patients 13 and older should be screened routinely for the HIV virus, whether or not they have engaged in risky behavior, urges the American College of Physicians (ACP).

The guidelines are slightly different than those imposed by the U.S. Centers for Disease Control and Prevention (CDC), which recommends routine screening until age 64 unless the prevalence of HIV is known to be 0.1 percent or less in the patient population.

The guidelines also deviate from those suggested by the U.S. Preventive Services Task Force, which urges routine screening only of those patients at increased risk of infection.

The problem is, most patients don’t discuss their risky behaviors with their doctor, said Dr. Amir Qaseem, senior medical associate with the American College of Physicians. And, it is near impossible for a doctor to know an HIV prevalence rate among certain patients, he said.

“An estimated 1 to 1.2 million Americans currently have the HIV virus, but 24 to 27 percent of them are unaware they are infected or remain undiagnosed,” Dr. Qaseem said. “We are recommending clinicians adopt routine screening in their patients.

Because 20 percent of people with HIV are over 50 years of age, the college does not impose an age limit for testing. Clinicians should decide on a case-by-case basis if repeat screening is necessary.

Only 50 to 100 of the nation’s 5000 emergency rooms routinely test for HIV, says Dr. Richard Rothman, associate professor of emergency medicine at Johns Hopkins School of Medicine, largely because of lack of funding.

Mandatory AIDS Testing

If the CDC would adopt control measures that include mandatory HIV testing among broad age groups, that would help to greatly reduce the number of new infections.

For patients that don’t visit the doctor regularly, blood test could be scheduled, with the results recorded by the agency.

HIV can go undetected for years and because all risk groups are not tested, 20 to 40 percent of Americans who are HIV-positive are unaware and often pass the virus on. This alone significantly contributes to the epidemic.

A person who is HIV-positive, but unaware they are infected, is three times more likely to transmit the infection than a person who is aware they have it.

In 2006, when the CDC recommended HIV testing for all patients as routine medical care, regardless of gender, age, color or social status, it was a giant step forward. But, nothing requires doctors to comply with this recommendation. And infection rates show voluntary testing has failed to curb the tide of the disease.

HIV Treatment & Babies

Pregnant women are not routinely tested for HIV. They must request to be tested and sadly, when a test returns a positive finding, there is no mandatory treatment or counseling for the patient nor does federal law require the patient to notify their sexual partner(s).

Early treatment for babies born with the virus that causes AIDS significantly increases their chances of survival, reports four U.N. agencies.

Too many pregnant women are unaware of their HIV status. In 2007, less than 10 percent of infants born to mothers HIV-positive, tested for the virus before the child was two months old, the report said.

“Without proper treatment, half of the children with HIV will die from HIV-related causes by their second birthday,” said Ann Veneman, executive director of the U.N. children’s agency.

“Survival rates are as much as 75 percent higher for HIV-positive newborns that are diagnosed and begin treatment within their first 12 weeks of life,” she said.

The report, by UNICEF, the World Health Organization, the Joint U.N. Program on HIV/AIDS and the U.N. Population Fund, calls for increased testing to enable adequate treatments to start as early as possible.

Yesterday marks 20 years since the first World AIDS Day was recognized by the World Health Organization (WHO) in 1988.

33 million people live with HIV, the virus that causes AIDS. #

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