“In an editorial, the New York Times (5/3, Subscription Publication, 1.68M) writes the United States Preventive Services Task Force “recommended that Americans aged 15 to 65 be voluntarily screened for H.I.V., the virus that causes AIDS, and that many of those found infected receive antiviral drugs even before symptoms develop.” The task force previously advised, in 2005, “screening only adolescents and adults at increased risk of infection, like men who have sex with men, but eschewed wider testing.” The panel now believes that the “net benefit of screening adolescents, adults and pregnant women is ‘substantial,'” as possibly over 200,000 Americans may be infected and not even know it. The Times believes that if these infections could be detected early, the patients would be “less likely to suffer severe illness and premature death,” and would limit the spread of the virus.” (AMA)
Blogfinger Medical Commentary: By Paul Goldfinger, MD
There have been great privacy concerns that have influenced the prior discussions of HIV screening. These new recommendations widen the screening net, but continue to insist that testing be voluntary, and I believe that is appropriate, although in a perfect world, everyone would be tested. There are about 1.2 million HIV persons in the US, and about 20-25% are unaware that they are positive.
This is such a complicated issue. For example, treating people with a positive test who have no symptoms means that the reasons to start medication have to do with goals such as reducing complications and perhaps reducing the risk of infecting others. But the usual precautions to prevent spread by positive individuals to negative individuals would not be changed just because someone is on therapy. And the goals of therapy do not include “cure.” No cure has been found so far.
You can read the report in the April 30, 2013 edition of the Annals of Internal Medicine (linked below)
Annals of Internal Medicine on HIV screening
I think a really important message that underlies this situation is that being positive for HIV is no longer a death sentence. Instead, with treatment, the condition has become more like a chronic disease. The treatments now available are well tolerated by most people, but those drugs can certainly cause problems, as can any drugs.
If any of you reading this find yourself with a positive test result, don’t shrug your shoulders just because you feel fine. See a specialist in HIV infections. There are some who practice in the Neptune area.