HIV screening: Difference between revisions
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Clinical practice guidelines conflict on the which populations should be screened with the [[HIV test]]. | Clinical practice guidelines conflict on the which populations should be screened with the [[HIV test]]. The conflict is whether the underlying prevalence to justify screening is 1% or 0.2%. | ||
The [[Centers for Disease Control]] states:<ref name="pmid16988643">{{cite journal |author=Branson BM, Handsfield HH, Lampe MA, ''et al'' |title=Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings |journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control |volume=55 |issue=RR-14 |pages=1–17; quiz CE1–4 |year=2006 |pmid=16988643 |doi=}}</ref> | The [[Centers for Disease Control]] states:<ref name="pmid16988643">{{cite journal |author=Branson BM, Handsfield HH, Lampe MA, ''et al'' |title=Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings |journal=MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control |volume=55 |issue=RR-14 |pages=1–17; quiz CE1–4 |year=2006 |pmid=16988643 |doi=|url=http://www.cdc.gov/mmwR/preview/mmwrhtml/rr5514a1.htm}}</ref> | ||
:"HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening)" | :"HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening)" | ||
:"Routine, rapid HIV testing is recommended for all adults except in settings where there is evidence that the prevalence of undiagnosed HIV infection is below 0.2%." | :"Routine, rapid HIV testing is recommended for all adults except in settings where there is evidence that the prevalence of undiagnosed HIV infection is below 0.2%." | ||
The [[US Preventive Services Task Force| U.S. Preventive Services Task Force]] states:<ref name="pmid15998753">{{cite journal |author= |title=Screening for HIV: recommendation statement |journal=Ann. Intern. Med. |volume=143 |issue=1 |pages=32–7 |year=2005 |pmid=15998753 |doi= | The [[US Preventive Services Task Force| U.S. Preventive Services Task Force]] states:<ref name="pmid15998753">{{cite journal |author= |title=Screening for HIV: recommendation statement |journal=Ann. Intern. Med. |volume=143 |issue=1 |pages=32–7 |year=2005 |pmid=15998753 |doi=|url=http://www.annals.org/cgi/content/full/143/1/32}}</ref> | ||
:"strongly recommends that clinicians screen for HIV all adolescents and adults at increased risk for HIV infection". Regarding the definition of increased risk, the Task Force states "High-prevalence settings are defined by the Centers for Disease Control and Prevention (CDC) as those known to have a 1% or greater prevalence of infection "<ref name="pmid15998753"/> | :"strongly recommends that clinicians screen for HIV all adolescents and adults at increased risk for HIV infection". Regarding the definition of increased risk, the Task Force states "High-prevalence settings are defined by the Centers for Disease Control and Prevention (CDC) as those known to have a 1% or greater prevalence of infection "<ref name="pmid15998753"/> | ||
A subsequent cost analysis supported the threshold of 0.2%.<ref name="pmid17146064">{{cite journal |author=Paltiel AD, Walensky RP, Schackman BR, ''et al'' |title=Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs |journal=Ann. Intern. Med. |volume=145 |issue=11 |pages=797–806 |year=2006 |pmid=17146064 |doi=|url=http://www.annals.org/cgi/content/full/145/11/797}}</ref> | |||
== Human rights == | == Human rights == | ||
Revision as of 12:36, 18 October 2007
Clinical practice guidelines conflict on the which populations should be screened with the HIV test. The conflict is whether the underlying prevalence to justify screening is 1% or 0.2%.
The Centers for Disease Control states:[1]
- "HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening)"
- "Routine, rapid HIV testing is recommended for all adults except in settings where there is evidence that the prevalence of undiagnosed HIV infection is below 0.2%."
The U.S. Preventive Services Task Force states:[2]
- "strongly recommends that clinicians screen for HIV all adolescents and adults at increased risk for HIV infection". Regarding the definition of increased risk, the Task Force states "High-prevalence settings are defined by the Centers for Disease Control and Prevention (CDC) as those known to have a 1% or greater prevalence of infection "[2]
A subsequent cost analysis supported the threshold of 0.2%.[3]
Human rights
The UNAIDS/WHO policy statement on HIV Testing states that conditions under which people undergo HIV testing must be anchored in a human rights approach which pays due respect to ethical principles.[4] According to these principles, the conduct of HIV testing of individuals must be:
- Confidential
- Accompanied by counseling
- Conducted with the informed consent of the person being tested
References
- ↑ Branson BM, Handsfield HH, Lampe MA, et al (2006). "Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control 55 (RR-14): 1–17; quiz CE1–4. PMID 16988643. [e]
- ↑ 2.0 2.1 (2005) "Screening for HIV: recommendation statement". Ann. Intern. Med. 143 (1): 32–7. PMID 15998753. [e]
- ↑ Paltiel AD, Walensky RP, Schackman BR, et al (2006). "Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs". Ann. Intern. Med. 145 (11): 797–806. PMID 17146064. [e]
- ↑ UNAIDS/WHO policy statement on HIV Testing (PDF), accessed 5 Oct 2006.