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Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement FREE

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The full report is titled “Screening for HIV: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 2 July 2013 issue of Annals of Internal Medicine (volume 159, pages 51-60). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

This article was published at www.annals.org on 30 April 2013.

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Ann Intern Med. 2013;159(1):I-36. doi:10.7326/0003-4819-159-1-201307020-00002
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Who developed these guidelines?

The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that reviews published research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

HIV is the cause of AIDS, an illness that interferes with the body's ability to fight infection and some types of cancer. Treatments containing multiple drugs have improved outcomes for HIV-infected patients. The virus passes from person to person through contact with blood or other bodily fluids that contain it. People can have HIV infection for years before becoming sick.

Men who have sex with men and active users of injected recreational drugs are at very high risk for HIV infection. Other risk factors include unprotected vaginal or anal intercourse; having sexual partners who are HIV-positive, bisexual, or injection drug users; exchanging sex for drugs or money; and having other sexually transmitted infections. Research also shows that people who request HIV testing despite reporting no risk factors are at increased risk for HIV infection, possibly because of risk factors that they do not report.

Conventional tests for HIV infection are blood tests that usually provide results in 1 to 2 days. Rapid tests that provide results in 5 to 40 minutes involve testing blood or saliva, but positive results must be confirmed with conventional blood tests.

In 2005, the USPSTF recommended that physicians ask patients about HIV risk factors, advise HIV testing for all adolescents and adults with a risk factor for HIV, and screen all pregnant women regardless of whether they have risk factors. Screening means testing people who feel well rather than waiting until symptoms develop. The USPSTF wanted to update these recommendations.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published research to evaluate the benefits and harms of HIV screening.

What did the authors find?

Conventional and rapid HIV tests are highly accurate in diagnosing infection. Research shows that identification and treatment of HIV infection greatly reduce the progression to AIDS. Early initiation of treatment is associated with fewer AIDS-related complications or deaths. Treatment reduces the transmission of HIV to uninfected heterosexual partners. The identification and treatment of HIV infection in pregnant women greatly reduces the passage of infection from mother to child. The harms of screening for and treating HIV infection in adolescents, adults, and pregnant women are probably small.

What does the USPSTF recommend that patients and doctors do?

All adolescents and adults aged 15 to 65 years should have HIV screening. Younger adolescents and older adults who have risk factors for HIV infection should also be screened.

All pregnant women should receive screening for HIV infection, including those who present in labor whose status is unknown.

What are the cautions related to these recommendations?

Patients with signs or symptoms of HIV infection should be tested regardless of whether they are in the aforementioned age and risk groups.





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