Benefits of Routine Screening
HIV Testing. Linkage to Care. The Time Is Now.
An estimated 1.1 million people in the United States have the human immunodeficiency virus (HIV), and approximately 1 in 7 (nearly 15%) are unaware of their status. About 40% of new HIV infections are transmitted by people undiagnosed and unaware they have HIV.
Diagnosing HIV quickly and linking people to treatment immediately are crucial to achieving further reduction in new HIV infections.1
Primary care providers (PCPs) are the front line for detecting and preventing the spread of HIV. The Centers for Disease Control and Prevention (CDC) is asking PCPs to2:
- Conduct routine HIV screening at least once for all their patients
- Conduct more frequent screenings for patients at greater risk for HIV
- Link all patients who test positive for HIV to medical treatment, care, and prevention services
Missed Opportunities for HIV Testing
Despite seeing a PCP, many people at high risk* for HIV are not getting tested every year.4 More than 75% of patients at high risk for HIV who saw a PCP in the last year weren’t offered an HIV test4 during their visit.
*Persons likely to be at high risk include: PWID and their sex partners, persons who exchange sex for money or drugs, sex partners of persons with HIV infection, and MSM or heterosexual persons who themselves or whose sex partners have had more than one sex partner since their most recent HIV test.
Benefits of Early HIV Diagnosis
People with HIV who are aware of their status should be prescribed ART and, by achieving and maintaining an undetectable (<200 copies/mL) viral load, can remain healthy for many years.5 ART is now recommended for all people with HIV, regardless of CD4 count.6 Studies show that the sooner people start treatment after diagnosis, the more they benefit from ART. Early diagnosis followed by prompt
- Reduces HIV-associated morbidity and mortality
- Greatly decreases HIV transmission to others
- May reduce risk of serious non-AIDS‒related diseases
Learn more about undetectable viral load and effectively no risk of transmission.
How Often Should Patients be Screened?
The CDC recommends that individuals between the ages of 13 to 64 get tested for HIV at least once as part of routine health care and that those with risk factors get tested more frequently. Patients who may be at high risk for HIV should be screened at least annually 2, 9:
- PWID and their sex partners
- People who exchange sex for money or drugs
- Sex partners of people with HIV
- Sexually active MSM (more frequent testing may be beneficial; e.g., every 3‒6 months)
- Heterosexuals who themselves or whose sex partners have had ≥1 sex partner since their most recent HIV test
- People receiving treatment for hepatitis, tuberculosis, or a sexually transmitted disease
Routine HIV Screening is endorsed by:
- CDC. HIV Surveillance Report: Estimated HIV Incidence and Prevalence in the US 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 pdf icon[PDF – 3 MB]. Published February 2019. Accessed March 28, 2019.
- 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.
- CDC. HIV Surveillance Report: Diagnosis of HIV Infection in the United States and Dependent Areas, 2017; vol 29. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2017-vol-29.pdf pdf icon[PDF – 6 MB]. Published November 2018. Accessed January 11, 2019.
- Dailey AF, Hoots BE, Hall HI, et al. Vital Signs: Human Immunodeficiency Virus Testing and Diagnosis Delays— United Statesexternal icon. MMWR Morb Mortal Wkly Rep 2017;66:1300–1306.(5)
- Bavinton B, Grinsztejn B, Phanuphak N, et al, for the Opposites Attract Study Group. HIV treatment prevents HIV transmission in male serodiscordant couples in Australia, Thailand and Brazilexternal icon. Presented at the 9th IAS Conference on HIV Science; July 25, 2017; Paris, France.
- USDHHS. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. https://clinicalinfo.hiv.gov/enexternal icon. Accessed June 28, 2018.
- Rodger AJ, Cambiano V, Bruun T, et al, for the PARTNER Study Group. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA 2016;316:171-181. PubMed abstractexternal icon.
- The INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N Engl J Med 2015;373:795-807. PubMed abstractexternal icon.
- DiNenno EA, Prejean J, Irwin K, et al. Recommendations for HIV screening of gay, bisexual, and other men who have sex with men ‒ United States, 2017. MMWR Morb Mortal Wkly Rep 2017; 66:830-832.