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Rapid Testing for HIV Antibody: A Technology Whose Time Has Come

Freya Spielberg, MD; and William J. Kassler, MD, MPH
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University of Washington Seattle, WA 98195 Centers for Disease Control and Prevention, Atlanta, GA 30333 Disclaimer: The views expressed in this editorial do not necessarily reflect the views of the Robert Wood Johnson Foundation. Acknowledgment: The authors thank Kevin Crean for his helpful editorial comments. Requests for Reprints: Freya Spielberg, MD, Robert Wood Johnson Clinical Scholars Program, University of Washington, 3747 15th Avenue NE, Room 203, Box 355300, Seattle, WA 98195. Current Author Addresses: Dr. Spielberg: Robert Wood Johnson Clinical Scholars Program, University of Washington, 3747 15th Avenue NE, Room 203, Box 355300, Seattle, WA 98195-5300.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;125(6):509-511. doi:10.7326/0003-4819-125-6-199609150-00014
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The benefits of widespread voluntary testing for human immunodeficiency virus (HIV) have been recognized since 1985, when the first antibody test for HIV became available. Recently, the reasons to promote the early diagnosis of HIV infection have become even more compelling. Research has shown that knowledge of HIV-positive serostatus combined with counseling can facilitate behavioral change [1], allows for partner notification, and may be a valuable tool in the public response to HIV prevention. In addition, mounting evidence shows that early antiretroviral therapy [2] and antibiotic prophylaxis for opportunistic infections [3] can improve the health of HIV-infected persons. Furthermore, knowledge of the HIV status of pregnant women allows treatment to be offered to prevent perinatal HIV infection [4]. Despite these benefits, many persons who are infected with HIV have never been tested [5], and those who are tested often learn their serostatus too late. One study [6] showed that one third of persons who tested positive for HIV were tested within 2 months of receiving a diagnosis of the acquired immunodeficiency syndrome. Given the long asymptomatic period of HIV infection, this represents missed opportunities for early medical treatment and prevention. Promoting knowledge of serostatus has become an important public health goal. The question of how best to provide HIV testing and counseling services to achieve this goal still remains. Irwin and colleagues [7] in this issue present data on the performance of a rapid test for HIV infection that may help answer this question.

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