HIV screening
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Clinical practice guidelines conflict on which populations should be screened for Human Immunodeficiency Virus with the HIV test. The conflict is whether the underlying prevalence of Human Immunodeficiency Virus to justify screening is 1% or 0.2%.
The Centers for Disease Control states:[1]
- "HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening)"
- "Routine, rapid HIV testing is recommended for all adults except in settings where there is evidence that the prevalence of undiagnosed HIV infection is below 0.2%."
The U.S. Preventive Services Task Force states:[2]
- "strongly recommends that clinicians screen for HIV all adolescents and adults at increased risk for HIV infection". Regarding the definition of increased risk, the Task Force states "High-prevalence settings are defined by the Centers for Disease Control and Prevention (CDC) as those known to have a 1% or greater prevalence of infection "[2]
A subsequent cost-benefit analysis supported the threshold of 0.2%.[3]
Human rights
The UNAIDS/WHO policy statement on HIV Testing states that conditions under which people undergo HIV testing must be anchored in a human rights approach which pays due respect to ethical principles.[4] According to these principles, the conduct of HIV testing of individuals must be:
- Confidential
- Accompanied by counseling
- Conducted with the informed consent of the person being tested
References
- ↑ Branson BM, Handsfield HH, Lampe MA, et al (2006). "Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control 55 (RR-14): 1–17; quiz CE1–4. PMID 16988643. [e]
- ↑ 2.0 2.1 US Preventive Services Task Force (2005). "Screening for HIV: recommendation statement". Ann. Intern. Med. 143 (1): 32–7. PMID 15998753. [e]
- ↑ Paltiel AD, Walensky RP, Schackman BR, et al (2006). "Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs". Ann. Intern. Med. 145 (11): 797–806. PMID 17146064. [e]
- ↑ UNAIDS/WHO policy statement on HIV Testing (PDF), accessed 5 Oct 2006.