Routine HIV screening – a proposed recommendation by the U.S. Preventive Services Task Force — is likely to remove important barriers that leave about 25% of HIV-positive people unaware they have the virus.
In two separate Perspective articles, published online in the New England Journal of Medicine, experts argue that the proposed recommendation has the potential for some far-reaching consequences, including getting more people into care, improving their health, and slowing the rate of transmission of HIV. The task force is suggesting an A grade for the recommendation, which would mean that most people under 65 would have access to HIV testing without an out-of-pocket cost.
The rationale for the task force draft recommendation, they noted, is that routine testing will lead to a “substantial” benefit.
Failure, they concluded, will have “measurable clinical consequences” for patients who do not get timely care as well as public health consequences, including failing to reduce HIV transmission. Success, on the other hand, will have other – mainly financial — consequences, as more people line up for care and treatment.
The Affordable Care Act should alleviate some of the concern about paying for treatment, they noted, but “health care reform will not fix all gaps in health care delivery.”
“In the case of HIV screening,” they concluded, “that benefit can be achieved only if people identified as HIV-infected are effectively linked to and retained in HIV care and are supported in adhering to an effective antiretroviral regimen.”