Young MSM at high risk for HIV should be screened every 3 months, study suggests
Screening young men who have sex with men every 3 months for HIV is cost effective and improves clinical outcomes compared with less frequent screening, researchers reported in Clinical Infectious Diseases.
They suggested changing CDC guidelines recommending that young men who have sex with men (MSM) — like all MSM — be screened for HIV annually.
“Young men who have sex with men account for one in five new HIV infections in the United States, yet more than half of young men who have sex with men and who are living with HIV don’t even know that they have it,” Anne Neilan, MD, MPH, an infectious disease specialist at Massachusetts General Hospital, told Healio.
“With so many youths with HIV being unaware of their status, this is an area where there are opportunities not only to improve care for individual youth but also to curb the HIV epidemic in the U.S.,” Neilan said. “Despite these numbers, the CDC previously determined that there was insufficient youth-specific evidence to warrant changing their 2006 recommendation of an annual HIV screening among men who have sex with men.”
Given the disproportionate impact of the HIV epidemic on young MSM, Neilan said screening for HIV more frequently than once a year could identify infections that would otherwise be missed.
For their study, Neilan and colleagues used data from the Adolescent Medicine Trials Network for HIV/AIDS Interventions regarding how often HIV occurs in each age group and the stage of disease at the time of diagnosis to project the probable results of screening every 3 months, every 6 months or yearly.
According to the study, the researchers assessed HIV incidences, screening acceptance, linkage-to-care/ART initiation, HIV transmission, monthly ART costs and HIV per-screening costs.
Compared with the status quo, screening high-risk young MSM every 3 months was not only cost effective, it reduced primary transmission of HIV through age 30 years by 40%, Neilan and colleagues found.
Neilan added, however, that the results did not apply to youth who do not meet high-risk criteria.
“If even the current CDC recommendations for annual HIV screening among young MSM could be fully met, important gains could be made both for the health of youth with HIV and in working toward our goal of ending the HIV epidemic,” she said.
The study demonstrated that screening every 3 months was cost effective, even if the screening program itself cost up to $760 per person screened, according to Neilan. She said the test costs $38 to $76, which suggests that a large additional investment in innovative HIV screening approaches for youth would be of good value in the U.S.