The CDC estimates that there are 56,000 transmissions of HIV in the U.S. each year. Of this number, the CDC estimates that half of new infections are caused by persons who are unaware of their status.
HIV screening among the general population is cost effective and the cost is comparable to other screenings and medical interventions.
Many people with HIV/AIDS are diagnosed very late in the disease process and are unable to fully benefit from the lifesaving HIV treatments available today. An estimated 40 percent of individuals with HIV are diagnosed within one year of developing AIDS—when it is often too late for them to fully benefit from the remarkable advances available today for the treatment of HIV disease. Identifying people with HIV disease earlier and connecting them with HIV care and treatment earlier results in better health outcomes and the delivery of more cost effective care.
The 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.
Additionally, studies have shown that people who know their HIV positive status are more likely to take precautions to reduce the spread of HIV disease.
Prenatal and Perinatal HIV Testing
Prenatal and perinatal HIV testing is one of the big success stories in HIV and public health. Between 1988- 1993 in the US, an estimated 1000-2000 children annually became infected with HIV through mother-to-child transmission. However, following the standardization of perinatal routine testing, the number dramatically decreased. By 2006, just over 100 babies were born with the infection annually in the US.
The CDC currently recommends that HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women. Repeat screening in the third trimester is also recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.
The CDC “One Test. Two Lives” campaign provides healthcare professionals with tools to test pregnant women for HIV infection to help reduce the number of infants born with HIV.
In 2006, the Centers for Disease Control and Prevention (CDC) issued Revised Clinical Guidelines on Routine HIV Testing for all patients in clinical settings. These guidelines profoundly changes the standards for HIV testing in the United States.
In 2013, the US Preventive Services Task Force designated Routine HIV Testing with an “A” grade, providing for greater coverage of routine testing services by federal and state coverage programs.
In 2014, CDC released Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations. 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.
HIV Testing Clinical Resources:
For urgent questions about HIV testing or HIV care, the following hotlines are available for providers, and staffed by physicians:
The Warmline (800-933-3413)
A national HIV/AIDS telephone consultation service, the Warmline provides expert clinical advice on HIV/AIDS management for health care providers. For those with limited access to expert consultation, to those with complex antiretroviral resistance dilemmas, the Warmline is available Monday through Friday, 8 a.m. to 8 p.m. EST. *Solicite una consulta en Español.
Perinatal HIV Hotline (888-448-8765)
A national Perinatal HIV consultation & referral service, the Perinatal Hotline provides around-the-clock advice on indications and interpretations of standard and rapid HIV testing in pregnancy as well as consultation on antiretroviral use in pregnancy, labor and delivery, and the postpartum period. Available 24/7.
The Perinatal HIV Consultation and Referral Service also links HIV-infected pregnant women with appropriate health care. Available 24/7.
The PEPline (888-448-4911)
A national clinicians’ Post-Exposure Prophylaxis hotline, the PEPline provides around-the-clock expert guidance in managing healthcare worker exposures to HIV and hepatitis B and C.
Callers receive immediate post-exposure prophylaxis recommendations. Available 24/7.
At-Home or Over-the-Counter Testing
“At-home” or “over-the-counter” (OTC) HIV testing has been a subject of discussion and debate for many years among HIV advocates, providers and the larger public. And OTC HIV test designed for widespread use was approved by the FDA in 2012 and is now widely available in pharmacies.
Along with the American Medical Association (AMA) and the CDC, AAHIVM produced the Coding Guide for Routine HIV Testing, a complete resource on HIV testing coding and reimbursement. Download a printable version of the Guide or order hard copy brochures.
Download: Coding Guide for Routine HIV Testing