HIV Screening Underutilized, Particularly in Physicians’ Offices

Universal HIV screening has been endorsed by the U.S. Centers for Disease Control and Prevention (CDC) and other groups, but has not been widely adopted by hospitals and outpatient health care providers. New data shows that the vast majority of young men seeking care in physicians’ offices are not screened. Experts are simultaneously exploring barriers to screening and possible mechanisms to routinize HIV testing and improve testing coverage. In a clinical review and education piece published July 12 in the Journal of the American Medical Association (JAMA), infectious disease experts cite insurance barriers, difficulty in assessing risk factors, and provider uncertainty regarding best practices and/or national testing recommendations as possible explanations for why HIV screening is not routinely conducted. This confusion could be due to the fact that in 2006, the CDC recommended HIV testing of adults and adolescents, but a systematic literature review conducted as part of the 2013 U.S. Preventive Services Task Force HIV screening recommendations found inconclusive benefit of universal screening versus targeted screening. Additionally, no single universal screening strategy (opt in versus opt out; standard laboratory testing versus point-of-care testing) proved superior. “Clinical and risk factor–based testing is inferior to routine testing for identifying infected patients […]