Back in 2006, the Centers for Disease Control and Prevention
called for virtually all patients younger than 65 admitted to hospitals or seen
in primary care and emergency rooms to be routinely tested for HIV on an opt-out
basis. To be more explicit, patients should automatically be tested unless they
specifically refuse. However, things don’t look too good today, two years after
the recommendation was made.
The Forum for Collaborative HIV Research, an independent
public-private partnership based at the George Washington University School of
Public Health and Health Services, found that only about 5 percent of patients
with evidence of serious illness are being routinely checked in hospital emergency
rooms for HIV, the virus that causes AIDS.
“HIV is a life-threatening disease that is so grossly
underdiagnosed and undertreated in this country. Testing for HIV should be as
routine as a flu shot. A few hospital are implementing routine testing in their
emergency departments, but these are few and far between,” Veronica Miller,
director of the Forum for Collaborative HIV Research said in a briefing on the
two-day Summit on HIV Testing in Washington. The Summit focused on the extent of HIV testing in the United States
and how it could be improved.
More exactly, about 50 to 100 out of 5,000 emergency rooms
in the US
are routinely testing all patients for HIV, according to Richard Rothman, M.D.,
Ph.D., of Johns Hopkins. Every pregnant women is supposed to be tested so steps
can be taken to protect her unborn baby. However, about 40 percent aren’t.
The reasons for which patients are not routinely tested for
HIV vary. Among them are the perception of many clinicians that it takes too
much time and the reluctance of some insurers to pay for the tests.
“Reimbursement is a major barrier to routine testing,” Kevin
Fenton, director of HIV prevention at the CDC, said. The testing consists of a
saliva test, followed if possible by a confirmatory blood test. If a patient is
charged, the cost is about $80 to $120.
Diagnosing a person with HIV in its early phase is very
important both for that person and for those whom he/she comes in contact with.
Treatment delays can lead to immune system damage and higher risk of cancer and
heart disease, Miller said.
The HIV-infected population in the US rose to 1.1 million in 2006 from
an estimated 994,000 in 2003, meaning that since 2003, HIV prevalence has
increased by 11 percent, or 112,000 people, according to a study of the CDC
released at the beginning of October.
The CDC previously reported that more people are becoming
infected each year than previously estimated, with 56,300 new HIV infections in
the US
in 2006. Previous estimates put the number of new infections at about 40,000 a
year.
Since 1981, when AIDS
first came to public notice, the
disease has killed at least 25 million people, and 33 million others are living
with the disease or HIV.
