Ending the HIV Epidemic Starts With HIV Screening

In February 2019, agencies across the U.S. Department of Health and Human Services, including the Centers for Disease Control and Prevention (CDC), announced their commitment to end the U.S. HIV epidemic within the next 10 years.¹ Achieving this goal will require continued dedication from nurse practitioners and physician assistants on the front lines. An essential step is routinely screening all patients for HIV and linking people who test positive to treatment and people who test negative to prevention resources, including pre-exposure prophylaxis and syringe service programs.

A recently released CDC Morbidity and Mortality Weekly Report (MMWR) indicates that HIV testing is well below where it needs to be in the United States, even in areas with a high burden of HIV and among populations known to be at high risk. This highlights the importance of screening to reduce new HIV infections. The report notes that HIV screening coverage in the United States remains low despite longstanding universal lifetime screening recommendations.²

Screen Early and Often
HIV screening and early diagnosis are critical to improve health outcomes for people with HIV and reduce the number of new infections. However, many people who should be getting screened for HIV aren’t. More than 75% of patients at high risk for HIV who saw a primary care provider in the last year were not offered an HIV test during their visit.²

CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once in their lifetime as part of routine health care. People at high risk for HIV should get tested at least once a year. Some sexually active gay and bisexual men may benefit from more frequent testing (every 3 to 6 months).³

Every patient represents a new opportunity to screen for HIV. And routine, opt-out screening helps to remove the stigma associated with HIV testing.

Tools to Help Screen Your Patients for HIV

CDC has information and tools that can help you integrate routine HIV screening into your practice.

Access the most up-to-date CDC HIV screening guidelines at www.cdc.gov/ScreenforHIV.

Read the MMWR on the importance of routine screening at https://www.cdc.gov/mmwr/volumes/68/wr/mm6825a2.htm.

Join the conversation to #ScreenforHIV at www.facebook.com/cdchiv/.

References

1. Azar A, Ending the HIV epidemic: a plan for America. U.S. Department of Health and Human Services website. https://www.hhs.gov/blog/2019/02/05/ending-the-hiv-epidemic-a-plan-for-america.html. Published February 5, 2019. Accessed July 30, 2019.  
   
2. Dailey AF, Hoots BE, Hall HI, et al. Vital signs: human immunodeficiency virus testing and diagnosis delays—United States. MMWR Morb Mortal Wkly Rep. 2017;66(47):1300-1306.  
   
3. Branson B, Handsfield HH, Lampe MA, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health care settings. MMWR Morb Mortal Wkly Rep. 2006;55(RR-14):1-17.
   
4. Centers for Disease Control and Prevention. HIV Surveillance Report, 2017; vol. 29. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf. Published November 2018. Accessed July 31, 2019.
   
5. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2010–2016. HIV Surveillance Supplemental Report 2019;24(No. 1). https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-24-1.pdf. Published February 2019. Accessed July 31, 2019.