WASHINGTON - The U.S.
government recommended near-universal testing for the AIDS virus on Thursday,
saying too many people are missed by the current practice of focusing on people
who seem to be at high risk.
Nearly everyone aged from 13 to 64 would be screened under the new proposals
issued by the U.S. Centers for Disease Control and Prevention. Pregnant women
would get extra screening to help ensure they do not pass the virus on to their
baby.
The human immunodeficiency virus that causes AIDS infects more than 1 million
people in the United States and the CDC estimates that 40,000 people become
newly infected every year. But many do not know it because HIV causes mild
symptoms at first, quietly destroying the immune system over time.
"We urgently need new approaches to reach the quarter-million Americans with
HIV who do not realize they are infected," said CDC Director Dr. Julie
Gerberding.
"People with HIV have a right to know that they are infected so they can seek
treatment and take steps to protect themselves and their partners."
AIDS is incurable, and infected people risk passing it to sex partners, to
their babies and in blood or shared needles. A cocktail of drugs, now available
in once- or twice-a-day single pills, can keep patients healthy, and patients
who use condoms reduce their risk of passing it along.
Current guidelines call for people considered at high risk to get tested for
the virus. But Dr. Bernard Branson, who is in charge of laboratory diagnostics
at CDC, said doctors were not always good at guessing who might be at high risk.
And people are often reluctant to admit to high-risk behavior, such as drug
use or anal sex, even to their doctors.
"Our goal is to ensure that everyone who receives medical care also has the
opportunity to learn if they are infected with HIV," said Dr. Kevin Fenton,
Director of CDC's National Center for HIV, STD and TB Prevention.
MAKING TESTING EASIER
"These new recommendations will make routine HIV screening feasible in busy
medical settings where it previously was impractical. Making the HIV test a
normal part of care for all Americans is also an important step toward removing
the stigma still associated with testing."
Branson said regularly testing teenagers would help make them start thinking
about AIDS early, before they begin having sex.
"Our data show that too many young people acquire HIV infection at relatively
young ages, oftentimes with very early partners," Branson told reporters.
The CDC estimates that between 16 million and 22 million HIV tests are
conducted in the United States every year.
AIDS experts welcomed the new recommendations, with some cautions.
The American Academy of HIV Medicine said it was important to allow patients
to opt out of the test easily, and to make sure they knew what it meant.
"We fear that the CDC's recommendations will lead to clinicians simply
telling the patient he or she will receive a test," the group's Dr. Michelle
Roland said in a statement.
Dr. Donna Futterman, head of the Adolescent AIDS Program at Montefiore
Medical Center in the Bronx in New York, said one study showed that 80 percent
of young men who had sex with other men did not know when they were HIV
infected.
"We are hoping that this new call for universal testing will reduce some of
the stigma," Futterman said in a telephone interview. "We don't have a medical
cure for HIV, we don't have a vaccine for HIV, but we certainly can find and
link to care all who have it."
