To read the CDC recommendations, "Missed Opportunities for Earlier Diagnosis of HIV Infection --- South Carolina, 1997--2005," please click here.
NEW YORK (Reuters Health) - In 2006, the US Centers for Disease Control and Prevention issued recommendations advising routine, opt-out HIV screening of persons aged 13 to 64 in all health care settings.
A review of HIV diagnoses made prior to 2006 reveals the magnitude of "missed opportunities" to diagnose HIV-positive individuals during the early stages of the disease.
Prior to 2006, the CDC recommended "risk based screening," which would include persons in high-prevalence settings, injection drug users, men who have sex with men, or those diagnosed with AIDS-associated illnesses.
In the CDC's Morbidity and Mortality Weekly Report this week, Dr. W. Duffus and associates report the details of a study linking two databases in South Carolina -- the HIV/AIDS Reporting System (HARS) and the Office of Research and Statistics -- for the period January 2001 and December 2005.
Duffus, at the South Carolina Department of Health and Environmental Control, and associates identified 4315 cases of HIV infection reported in South Carolina during that period.
Of these, 41 percent were in persons in whom AIDS was diagnosed within 1 year of their initial HIV diagnosis, despite the fact that 73 percent had visited a health-care facility at least once between 1997 and 2005, prior to their HIV diagnosis.
Among diagnoses made during that period, more than three-fourths would not have prompted a test for HIV under a risk-based testing strategy.
Thus, "HIV testing practices in South Carolina failed to identify a substantial proportion of HIV-infected persons early in the course of their infection," MMWR editors conclude.
They say the finding underscores "the need for routine HIV screening of adults and adolescents visiting healthcare facilities." However, they point out, "The capacity of treatment and preventive services will need to be increased if HIV testing is made routine."
SOURCE: Morbidity and Mortality Weekly Report, December 1, 2006.
