In the Journals Plus

Many high-risk patients report not being tested for HIV at clinical visit

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June 26, 2018

Despite CDC guidance that high-risk individuals be tested for HIV at least annually, about half of men who have sex with men and people who inject drugs in the United States who were unaware of their HIV infection reported not being offered testing in the past year even though they had visited a clinician, according data published today in JAMA.

The CDC estimates that 15% of people living with HIV in 2015 were unaware of their infection. These patients accounted for approximately 40% of HIV transmission in the U.S., according to Cyprian Wejnert, PhD, epidemiologist in the CDC’s Division of HIV/AIDS Prevention, and colleagues.

“Many HIV infections among [men who have sex with men (MSM)] and [people who inject drugs (PWID)] could be diagnosed sooner if HIV testing were more frequently offered during clinical visits,” they wrote.

The researchers examined data from CDC’s National Behavioral Surveillance network to investigate missed opportunities for HIV testing and diagnosis in clinical settings. Their analysis included 9,105 MSM and 19,357 PWID in 19 U.S. cities who participated in an anonymous interview and subsequent HIV test.

Overall, 22% of MSM and 8% of PWID were positive for HIV. Among them, 8% of MSM and 12% of PWID were unaware of their infection.

Most MSM (81%) and PWID (65%) who were unaware of their infection reported visiting a clinician in the past year. However, only 43% of MSM and 24% of PWID were offered an HIV test by a clinician. Of 44% of MSM and 77% of PWID who were not tested for HIV in the past year, 52% and 45%, respectively, had a health care visit at some point and reported not being offered HIV testing.

Similarly, another recent study led by CDC researchers showed that two-thirds of patients newly diagnosed with HIV had missed opportunities for pre-exposure prophylaxis. These patients had, on average, 6.9 recent health care visits before their diagnosis.

“Eliminating missed opportunities for HIV testing and diagnosis in health care settings may reduce HIV transmission, especially among high-risk groups,” Wejnert and colleagues concluded. “Clinicians should routinely screen patients for HIV and identify persons with ongoing risk to ensure they are screened annually.” – by Stephanie Viguers

Disclosures: The authors report no relevant financial disclosures.

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