Role of testing in stopping HIV/AIDS

There are approximately 1.2 million people living with HIV in the United States. Studies suggest that 20% of HIV-infected persons who are unaware of their status are responsible for approximately 49% of HIV transmission in the United States. Given this statistic, testing for HIV plays a critical role in the prevention of future HIV infection.

The remaining 80% of people living with HIV in the United States are aware of their infection. Of those:

  • 62% are currently receiving some form of care for their HIV infection
  • 41% of people living with HIV remain in care with 36% and 28%, respectively, being treated with antiretroviral therapies and having a suppressed viral load.

While there has been an increase in HIV testing in past decades, there are approximately 236,000 individuals in the United States who are unaware that they are HIV-positive. It is critical that we work to decrease the number of persons who are unaware that they are living with HIV. In addition, it is critical that a larger amount of people who are currently living with HIV seek treatment and remain in care well into their lives. An increased effort must be made to provide the necessary tools to aid people living with HIV at each stage of care.

Upon testing positive for HIV, it is vital that health care providers immediately help people living with HIV identify appropriate treatment options and care. The CDC continues to support increased HIV testing in the United States, and especially by populations who are disproportionately at risk for HIV. In an attempt to increase HIV screening, in 2006, the CDC modified a list of recommendations in an initiative developed in 2003 that sought to increase the accessibility of diagnosis and services for HIV positive individuals.

The amended recommendations for the HIV testing for Adults, Adolescents and Pregnant Women in Health-Care settings included:

  1. opt-out HIV testing for patients
  2. informing populations who are disproportionately at risk for HIV they should be screened at least once a year
  3. medical care consent should include HIV testing on a similar level as other screening or diagnostic tests
  4. should patients elect to undergo HIV testing for screening for diagnostic reasons, it is advised that prevention counseling should not be required, and
  5. HIV testing should be a regular element of prenatal screening.

HIV screening should be considered a regular component of clinical practice for individuals. Given that approximately 236,000 people in the United States today are unaware they are infected with HIV, establishing HIV screening among all populations as part of one’s clinical routine will work to decrease the number of people who are unaware of their status. In addition, the recommendations proposed by the CDC work to decrease the barriers associated with HIV testing. The CDC’s recommendations have enabled healthcare providers to perform HIV testing at a faster pace. This is especially important in locations where timing is of the essence, such as jails and clinical care settings. In 2006, the CDC’s efforts allowed for more than 18,000 new diagnoses of HIV infection.