Some doctors now say it may be only a matter of time before HIV
screening is just as commonplace as testing for blood pressure or
cholesterol levels.
Last month, the U.S. Centers for Disease Control and Prevention
recommended that HIV screenings should be a routine part of medical
care for patients ages 13 to 64.
According to the organization’s press release, the
recommendations aim to simplify the HIV testing process and
increase early HIV diagnosis among the estimated 250,000
HIV-positive Americans who are unaware of their infection.
“This is a major shift; before, the test was not
recommended to be used routinely for all patients, only pregnant
women and those who have risk factors,” said Dr. Jaime
DeVille, assistant clinical professor of pediatrics at the Mattel
Children’s Hospital at UCLA.
David Estrada, a first-year physiological science student, said
he expects routine HIV testing will change the testing rate among
students.
“A lot of people that normally wouldn’t have the
chance to do it … would have no excuse not to be tested,”
he added.
The CDC’s recommendations strongly emphasize that HIV
testing must be voluntary and undertaken only with the
patient’s knowledge, with the patient having the opportunity
to decline testing.
But some are worried that HIV screening could slide into testing
without knowledge or consent, bringing up privacy issues.
DeVille said if routine HIV screening were to be adopted by most
primary-care providers, legal challenges relating to privacy would
probably slow down the process.
Opponents of routine testing also bring up other concerns,
including fear of coercion and discrimination against particular
groups.
Wendy Mariner, Boston University professor of health law, said
some people fear that a positive test will result in loss of
insurance or employment.
But people now in Medicaid, Medicare or group health policies
cannot be excluded if they test positive, she told the Wall Street
Journal. Insurance plans can, however, cap medical payments,
forcing patients to pay a larger proportion of their bills, she
said.
Proponents are confident that more HIV screenings will help
increase prevention.
“The more tests we do, the more infected patients will be
discovered,” DeVille said.
Assuming the current frequency of HIV infection in some U.S.
cities, every 200 to 300 patients that are tested routinely will
yield one positive individual, DeVille said.
The CDC also cites studies showing that most people who learn
they are infected take steps to protect their partners.
People are often unaware of HIV infection because the immune
system can remain intact for 8 to 10 years after infection, and
many infected people who don’t have symptoms of physical
illness continue to transmit to others, DeVille said.
Nearly 40 percent of individuals diagnosed with HIV today are
diagnosed within one year of the infection progressing to AIDS,
when it may be too late for them to fully benefit from treatment,
according to the CDC.