HIV Testing in Clinical Settings

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• The U.S. Preventive Services Task Force (USPSTF) recommends that clinicians screen adolescents and adults ages 15 to 65 years for HIV infection.
• CDC recommends that individuals get tested at least once in their lifetimes and those with risk factors get tested more frequently. A general rule for those with risk factors is to get tested at least annually.
• CDC has recently reported that sexually active gay and bisexual men may benefit from getting an HIV test more often, perhaps every 3-6 months.

When should clinicians start treatment for HIV?

• New data from a National Institutes of Health sponsored trial indicates there is a clear personal advantage to achieving an HIV diagnosis and starting therapy in the early course of infection. This new information further highlights the importance of routine HIV testing and the potential impact on better health outcomes. See Starting Antiretroviral Treatment Early Improves Outcomes for HIV-Infected Individuals for more information.

Recommendations and Guidelines

• The 2013 U.S. Preventive Services Task Force (USPSTF) recommendations on HIV Testing
• Sexually Transmitted Diseases Treatment Guidelines
• Pre-Exposure Prophylaxis (PrEP)
• Post-Exposure Prophylaxis (PEP)
• Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health Care Settings.
  • PDF version

HIV testing implementation in various settings

Hospitals and Emergency Departments

• Increased HIV testing among hospitalized patients who declined testing in the emergency department. AIDS Care, 2016.
• Patient choice in opt-in, active choice, and opt-out HIV screening: randomized clinical trial. BMJ, 2015.
• Routine HIV screening in two health-care settings–New York City and New Orleans, 2011-2013. MWR – Morbidity & Mortality Weekly Report, 2014.

STD clinics

• The cost of implementing rapid HIV testing in sexually transmitted disease clinics in the United States.
  Sexually Transmitted Diseases, 2014.

Primary Care

• Assessment and improvement of HIV screening rates in a Midwest primary care practice using an electronic clinical decision support system: a quality improvement study. BMC Medical Informatics & Decision Making, 2016.
• Increases in HIV screening in primary care clinics through an electronic reminder: an interrupted time series. BMJ Quality & Safety, 2013.
• Implementation of Routine HIV Testing in Health Care Settings: Issues for Community Health Centers. CDC, 2011.

Family Planning clinics

• Integrating Routine HIV Testing into Family Planning Clinics That Treat Adolescents and Young Adults. Public Health Reports, 2016.
• Integration of routine rapid HIV screening in an urban family planning clinic. Journal of Midwifery & Women’s Health, 2011.

Substance Abuse programs

• Implementing HIV Testing in Substance Use Treatment Programs: A Systematic Review. Journal of the Association of Nurses in AIDS Care, 2015.

Pharmacies

• Point-of-care testing for infectious diseases: opportunities, barriers, and considerations in community pharmacy.
  Journal of the American Pharmacists Association, 2014.

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