Today, I review, link to and excerpt from Clinical Testing Guidance for HIV from U.S. Centers For Disease Control And Prevention (CDC).
All that follows is from the above resource.
Key points
- CDC recommends all patients between the ages of 13 and 64 get tested for HIV at least once as part of routine health care.
- Screen patients who may have ongoing risk factors for HIV at least annually.
- Use “opt-out” approach to remove stigma associated with HIV testing and foster earlier diagnosis and treatment.
- Try conversation starters to talk with your patients about routine HIV screening.
- Know your state’s HIV testing laws and regulations.
Offer HIV screening to all your patients
HIV crosses the boundaries of sexual orientation, gender, age, and ethnicity. More than 1 million people in the United States have HIV, and many are unaware of their status. About 40% of new HIV infections are transmitted by people who are unaware they have HIV.1 Diagnosing HIV quickly and linking people to treatment immediately are crucial steps to reducing new HIV infections.1
Use an “opt-out” approach
Risk-based screening may fail to identify some people with HIV. These people include women, members of minority races/ethnicities, nonurban dwellers in low-incidence areas, and people under 20 years of age. It also includes heterosexual men and women who are unaware of their likelihood of getting of HIV. As a result, many people with HIV are not diagnosed until they have advanced HIV or AIDS.
Routine, opt-out screening has proven to be highly effective because it:
- Removes the stigma associated with HIV testing.
- Fosters earlier diagnosis and treatment.
- Reduces chances of transmission.
- Is cost-effective.
Inform patients (e.g., through a patient brochure, practice literature/form, or discussion) that an HIV test will be included in the standard preventive screening tests. Be sure to let them know that they may decline the test.2 A patient’s decision to decline testing should be noted in their medical record. HIV prevention counseling is not a requirement for HIV testing.
Recommended tests
HIV testing is easier than ever.
- Three types of HIV tests are available.
- Each type of HIV test has its own testing window, with the nucleic acid tests (NAT) capable of detecting HIV the earliest.
- HIV self-tests are also available for patients who want to test at home or in a private location.
There are three types of HIV Tests
- Nucleic acid tests (NATs) detect HIV ribonucleic acid (RNA).
- Antigen/antibody combination tests detect HIV p24 antigen as well as HIV immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies.
- Antibody tests detect HIV IgM and/or IgG antibodies.
Each type of HIV test has its own testing window
Today’s diagnostic tests reduce the time to diagnosis and treatment of early HIV infection by decreasing the window period.67 Following an exposure that leads to HIV infection, the time during which no diagnostic test can detect HIV is called the eclipse period.7 In contrast, the window period is the time between a potential HIV exposure and an accurate test result.
Different kinds of HIV tests have different eclipse periods.
