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Public release date: 01 December 2008
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US routine testing HIV and AIDS
Despite call for routine exams, 60,000 Americans were infected last year
Two years after U.S. health officials recommended routine HIV testing for Americans 13 to 64, such testing remains hit-and-miss, and the AIDS epidemic marches on.
This, despite the new testing guidelines and better testing methods, according to participants at a conference in suburban Washington D.C. The meeting was designed to review the state of the AIDS epidemic and the unmet role that routine testing can play.
"It's fast, it's cheap, it's easy, it's almost perfect in terms of positive or negative results, and it detects a lethal disease that can now be treated," Dr. John Bartlett, professor of medicine at the Johns Hopkins University School of Medicine's division of infectious diseases, said during a Thursday teleconference. "It's highly cost-effective and it deals effectively with a major public health problem. This is a slam dunk."
More than 1.1 million Americans are now living with HIV, the virus that causes AIDS. And more than 56,000 Americans were newly diagnosed with the virus in 2006, officials said.
"While significant progress has been made in the two years since the U.S. Centers for Disease Control and Prevention recommended routine testing, we are still nowhere near this being the national norm," said Veronica Miller, executive director of the Forum for Collaborative HIV Research, an independent public-private partnership that organized the conference. "Testing for HIV should be as routine as a flu shot, she said.
Testing can save lives. Statistics show that before 2006, hospital emergency rooms tested patients for HIV at a rate of just 3.2 per 1,000 visits -- or 0.32 percent. In the two years since, there's been slight improvement, with an estimated 50 to 100 out of 5,000 emergency rooms nationwide routinely testing for HIV, according to Dr. Richard Rothman, of the Johns Hopkins University Department of Emergency Medicine.
A lack of testing occurs in other settings as well, such as correctional facilities and Veterans Administration hospitals. Other research presented at the conference found that just 36 percent of insured individuals seeking treatment for sexually transmitted diseases -- a high-risk group -- were tested for HIV.
And under-testing, of course, means that people who are infected don't start their treatment until later. One study found that 40 percent of patients newly diagnosed with HIV were "late testers," meaning they had AIDS diagnosed within one year of their test.
Despite legislative, medical and social barriers, there have been some successes. They include a voluntary rapid HIV testing program in New York City jails that increased testing from 6,500 to 25,000 inmates between 2004 and 2006. And a Chicago hospital added two health educators to its emergency room, offering rapid testing to patients admitted for medical services. Over 15 months, nearly 2,000 patients were tested, and 15 percent were confirmed HIV-positive. They were set up with care, according to a conference news release.
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