Task Force Recommends HIV Screening For All Adolescents And Adults

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Early detection of a disease goes a long way in providing timely treatment. The U.S. Preventive Services Task Force is now urging clinicians to screen adolescents and adults aged 15 to 65 years for HIV infection, irrespective of their risk of contracting the disease.

All pregnant women, including those in labor who are untested and whose HIV status is unknown, and people younger than 15 years and older than 65 years if they are at increased risk should also be screened, according to the new guidelines.

The HIV screening tests include the conventional serum test, rapid HIV tests, combination tests (for p24 antigen and HIV antibodies) and qualitative HIV-1 RNA qualitative assay.

The earlier recommendations laid out by the U.S. Preventive Services Task Force, or USPSTF, in 2005, required that clinicians screen for HIV only those adolescents and adults at increased risk for HIV infection, as well as all pregnant women.

The new recommendations of the task force are based on evidence which showed that initiating the treatment for HIV earlier reduces the risk for AIDS-related events or death substantially and lowers the risk of virus transmission from HIV-positive persons to uninfected heterosexual partners.

In concurrence with CDC's recommendations, the task force also advocates that HIV screening should be voluntary; patients should be informed orally or in writing that HIV testing will be performed unless they decline (opt-out screening), and before HIV testing, patients should receive an explanation of HIV infection and the meaning of positive and negative test results.

Owing to insufficient evidence to determine optimum time intervals for HIV screening, the task force has not recommended the screening intervals. However, the task force considers a 1-time screening of adolescent and adult patients to identify persons who are already HIV-positive, with repeated screening of those who are known to be at risk for HIV infections as a reasonable approach.

The recommendations are published in the Annals of Internal Medicine.

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