U.S. health care providers should implement a policy of routine HIV antibody testing for all patients between the ages of 18 and 65, according to a letter from Brown University researchers published in the March 15 edition of the Journal of Infectious Diseases. The policy would mark a sharp change in the nation's approach to HIV testing, shifting from focusing on testing people at risk for HIV infection to testing the vast majority of the general public.
The letter's authors write that a widespread testing plan would help identify people with HIV infections who typically would be considered at medium or low risk for the disease, including heterosexuals with few sex partners. The researchers say that in Rhode Island, the home state of Brown University, the average heterosexual woman testing positive for HIV antibodies has had a median of fewer than three sex partners during the previous 10 years, putting them in the low-risk category.
The letter said routine testing also would eliminate the need for health care providers to obtain sexual and risk histories from patients to determine if they are at risk for infection; would help destigmatize HIV tests since the vast majority of the population would be regularly taking them; and would help get HIV-positive people into care before their infections progress to dangerous AIDS-related complications. "Offering routine HIV testing would be analogous to the current standard of care that indicates routine offering of Pap smear tests to women between the ages of 18 and 65 years, irrespective of risk," the researchers wrote.