Screening for HIV
What is HIV?
HIV (human immunodeficiency virus) is the virus that causes AIDS (acquired immune deficiency disease syndrome). A person infected with HIV can pass the virus to others through blood, semen, or vaginal secretions. HIV is not passed to others through ‘casual contact’ (ie, contact that does not involve blood or body fluids).
I haven't heard much about HIV and AIDS in recent years, isn’t it on the decline?
In the United States, about 1.1 million persons age 13 years and older are living with HIV/AIDS. Over the past decade, the number of people living with HIV has increased. However, almost 1 in 5 are unaware they are infected. Also, the number of new cases has not declined. It remains relatively stable at 50,000 new cases per year.
More locally, of the 4,547 known cases of HIV in Cuyahoga County (2012 data), about 900 are in people who did not know they were infected with HIV.
Does the Cleveland Clinic encourage patients to be screened for HIV?
Yes, the Cleveland Clinic recommends that patients be offered HIV screening. Many physician and health organizations recommend that screening be offered as part of routine medical care. For starters, the US Centers for Disease Control (CDC) and Prevention is recommending this. The Infectious Disease Society of America -- another professional organization of infectious disease specialists -- also supports the CDC’s recommendations; so does the director of the National Institutes of Health. The American College of Physicians -- the world’s largest professional organization of internists -- also encourages all patients to be tested and that clinicians adopt the CDC’s routine screening guidelines for their patients. The screening recommendation has also been adopted by the United States Prevention Services Task Force.
What are these screening guidelines?
The CDC’s screening guidelines are as follows:
- HIV screening is recommended in adults, adolescents, and pregnant women in all health care settings. Patients can turn down the offer to be screened.
- Persons at high risk should be screened at least annually. Examples that put a person at high risk include sex partners of HIV infected persons, persons who exchange sex for money or drugs, heterosexual or male-to-male sexual partners who themselves or whose sex partner has had more than one sex partner since their most recent HIV test; use of nonprescription injectable drugs; recent sexually transmitted infection.
Why should I consider getting screened?
Screening only those patients who are considered at high risk has failed to curb the HIV epidemic. Approximately half of the HIV transmissions in the United States are from persons infected with HIV who are not aware of their status. Some 36% of patients diagnosed with HIV progress to AIDS in less than 12 months.
HIV is a preventable disease. The more you know about your HIV status; the greater the chance that your health, and that of others, can be appropriately managed. HIV testing is also more acceptable today than it was at the start of the epidemic.
What if screening reveals that I am HIV positive? What are the advantages of knowing?
The advantages of discovering you are HIV positive early in the disease process are as follows:
- Data shows that starting HIV treatment early improves survival
- Early treatment benefits a patient’s immune system (the body’s defense against infection and disease)
- Knowledge that you have HIV will allow you to adopt protective measures and decrease any risky behavior
So bottom line, what is the Cleveland Clinic's recommendation regarding HIV screening?
The Cleveland Clinic recommends that:
- All patients 13 to 65 years of age, seen by a Cleveland Clinic primary care physician or internist, are offered an HIV screening test.
- Persons who request to be tested again or those at high risk of HIV should be offered testing on an annual basis.
Most major insurance payers will reimburse for screening, but it is best to check with your payer prior to your screening.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 11/13/2013…#14514