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HIV and Enteropathy
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Routine HIV Testing

Routine HIV Testing, or Routine HIV Screening, is the practice of making regular HIV testing a routine part of medical care.  


Background:

 

In 2006, the Centers for Disease Control and Prevention (CDC) issued the Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings which endorsed making HIV testing a part of routine medical care for people ages 13 to 64 in all healthcare settings.

 

These recommendations for HIV testing are intended for all health-care providers in the public and private sectors, including those working in hospital emergency departments, urgent care clinics, inpatient services, substance abuse treatment clinics, public health clinics, community clinics, correctional health-care facilities, and primary care settings.The recommendations address HIV testing in health-care settings only, and are as follows:
 
 For patients in all health-care settings:
 
  • 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).
  • Persons at high risk for HIV infection should be screened for HIV at least annually.
  • Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
  • Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in health-care settings.
For pregnant women:
 
  • HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
  • HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
  • Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
  • Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women
 
Latest: 
 
In 2014, CDC released a new algorithm for labortory tests used in HIV Testing. The algorithm includes recommendations for early identification of those with acute HIV infection through the use of HIV combination tests which can detect both HIV antigen as well as antibodies.
 
See More: 
 
Coverage:
 
In April 2013, The U.S. Preventive Services Task Force (USPSTF) issued a revised and updated Final Recommendation Statement on Routine HIV Testing. In the decision, the USPSTF recommends the following: 
  • The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk should also be screened. (Grade A)
  • The USPSTF recommends that clinicians screen all pregnant women for HIV, including those who present for labor who are untested and whose HIV status is unknown. (Grade A)
 
Linkage to Care: 
 
One of the most important aspects of routine testing, is the linking of patients who are identified to be infected with HIV to regular medical care.
 
Identifying people with HIV disease earlier and connecting them with HIV care and treatment earlier results in better health outcomes results in better health outcomes for patients and the delivery of more cost effective care.
 
Regular medical care, including the monitoring of disease progression by medical professionals, and the appropriate intervention of drug treatment is necessary to maintain to the health of patients.
 
The regular use of antiretroviral therapy by infected persons also drastically reduces their infectiousness. So identifying those with the disease offers a significant public health opportunity to get infected individuals into care and treatment, and also prevent others from contracting the disease.
 
ReferralLink is the AAHIVM directory of HIV care providers throughout the United States. Referral LInk is designed to assist the linkage of HIV patients to HIV care. 
 
Resources on Routine HIV Testing

AAHIVM Routine Testing Toolkit -  In partnership with the CDC, AAHIVM developed a Routine HIV Testing Toolkit to help providers learn about and implement the routine HIV testing in their practice.
 
The toolkit includes a Report on Best Practices in HIV Testing and Linkage to Care, a Physician Primer on Routine Testing, and a PowerPoint presentation on implemenating routine testing. These resources can be downloaded online, or a CD Rom can be ordered from AAHIVM for free.

AAHIVM Coding Guide For Routine TestingAAHIVM, along with the American Medical Association (AMA), and the CDC  produced a complete resource on billing and coding for HIV testing services to attain reimbursement. Download a printable version of the  Coding Guide for Routine HIV Testing or order hard copy brochures from AAHIVM by calling 202-659-0699 x11.

Additional Information: 


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