Thursday, 4:30 PM
Health officials urge routine AIDS tests for adults
By Stephen Smith, Globe Staff
Most adults and all adolescents should be routinely tested for the AIDS virus, federal health authorities said today as they announced a major shift in health policy designed to make HIV screening as common as blood pressure readings or cholesterol tests.
Disease trackers estimate that 250,000 Americans are infected with HIV but don't know it, and the number of people newly exposed each year has remained stuck at 40,000, frustrating health specialists. It is not uncommon in the United States for people to carry the virus for 10 years or longer and not be aware they're infected, specialists said.
Dr. Julie L. Gerberding, director of the US Centers for Disease Control and Prevention, said that the guidelines are intended to identify infections sooner, get patients into treatment quicker, and prevent further transmission of the virus, which is believed to infect 1 million Americans.
"When people know they're positive, the research has shown they take steps to protect others from infection," Gerberding said. "People who don't know it continue to transmit the virus."
During the first quarter-century of the epidemic, testing was largely confined to members of groups known to be at especially high risk for carrying HIV: gay men and injection drug users, for example. And testing for the AIDS virus was performed only after receiving counseling in advance and specific written permission.
The CDC recommendations would change that. Now, all adolescents and adults up to the age of 64 would be told during a visit to the doctor's office or the hospital that they should be screened for HIV. Patients would still have the option to decline.
"Patients should be specifically informed that HIV testing is part of routine care they're receiving and that they have the opportunity to opt out," said Dr. Timothy Mastro, acting director of HIV/AIDS Prevention at CDC.
Those patients believed to be at low risk of catching HIV would typically undergo a single screening and would not have another test unless their behaviors changed. Injecting drug users and patients with multiple sexual partners would be encouraged to undergo annual testing.
Dr. Daniel R. Kuritzkes, a leading AIDS specialist at Brigham and Women's Hospital, said in an interview that in the early days of the epidemic, there were legitimate concerns that routine testing might expose patients to the stigma that was so rampant then.
"I'm confident that now, 25 years into the epidemic, we can safeguard individual rights and confidentiality," said Kuritzkes, who is also chairman of the HIV Medical Association, a confederation of AIDS specialists. "There's no doubt this is the right thing to bring the epidemic under better control in the United States."
