Indiana University health policy expert Beth Meyerson said the U.S. Preventive Services Task Force's draft recommendation that clinicians screen for HIV infection in people age 15 to 65 could play an important role in normalizing HIV screening and ultimately could save lives.
The recommendation, like one recently released for hepatitis C, is "based on sound public health science" and is designed to help identify people who need to receive treatment.
"In both cases, the diseases are stigmatized, despite our years of awareness about them, so people tend to shy away from testing for them, and providers tend not to offer testing to their patients," said Meyerson, an assistant professor at the IU School of Public Health-Bloomington and co-director of the Rural Center for AIDS/STD Prevention. "There is some evidence that some providers do not offer testing because they are concerned about upsetting their patients."
Meyerson said that normalizing HIV screening is an important part of the public health response to a disease that can be identified, treated and controlled in populations.
"The key here is testing," she said. "In the U.S., 20 percent of the people living with HIV do not know they have it. Forty percent of the people who test positive learn of their status within a year of an AIDS diagnosis, which is well into the disease process. We want people to learn about their HIV status early, so they can access treatment that will not only improve their lives but will likely save the lives of their partners. Research has shown that transmission of HIV among sexual partners is significantly decreased when the virus is under control."
The draft recommendation calls for one-time screenings of adolescents and adults with follow-up screenings determined by risk factors for contracting HIV. Some people might warrant screenings at least annually, while others might not require any more screenings. The recommendation calls for all pregnant women to be screened. People younger than 15 and older than 65 also should be screened if they are at an increased risk for infection.
Comments will be received concerning the recommendation until Dec. 17. The task force will consider the comments when crafting its final recommendation. More information about the recommendation and process is available online.
Meyerson's research interest is focused on health system flexibility to expand access for populations experiencing health inequalities, particularly for HIV, STDs and cervical cancer. One of Meyerson's current studies evaluates whether pharmacies offer opportunities for HIV testing. Meyerson leads a team of colleagues from Indiana University and Butler University College of Pharmacy and Health Sciences to evaluate the acceptability, feasibility and readiness for pharmacy-based HIV testing. This study focuses on pharmacist provided HIV testing as well as pharmacy opportunities for public health engagement with over-the-counter HIV rapid home tests.
