Conference on Retroviruses and Opportunistic Infections (CROI)

Conference on Retroviruses and Opportunistic Infections (CROI)

February 29, 2016
2 min read

More than 50 million US adults not screened for HIV during routine doctor visits

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Data analysis indicated that nearly 100 million adults in the United States had never been tested for HIV, according to data presented at the Conference on Retroviruses and Opportunistic Infections.

More than half of this population had missed a recent opportunity for HIV testing during a routine doctor visit.

"In 2006, CDC recommended that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care," Michelle Van Handel, MPH, told Healio Internal Medicine. "These guidelines were supported in 2013 by the United States Preventive Services Task Force’s (USPSTF) call for clinicians to routinely screen adolescents and adults ages 15 to 65 years for HIV infection. Knowledge of HIV status is key to accessing effective HIV prevention and treatment and it’s important to improve knowledge among health care providers of the CDC and USPSTF recommendations."

Van Handel and Patricia Dietz, DrPH, MPH, used data from the 2011-2013 Behavioral Risk Factor Surveillance System to estimate the number of people aged 18 to 64 years who had never been screened for HIV both nationally and by state.

Results showed that an estimated 96.9 million adults (95% CI, 96.1-99.7) had never been tested for HIV in 2013. Of this group, 59.7 million adults (95% CI, 59.1-60.4) had a recent routine doctor visit.

The percentage of adults never tested ranged from 22.8% in the District of Columbia to 71.7% in Utah. The researchers reported that missed opportunities ranged from 50.5% in Oregon to 75.7% in Rhode Island.

Adults with missed opportunities were more likely to be female (52.5%), non-Hispanic white (69.8%), have health insurance coverage (88.6%) and be between 45 and 64 years old (56.4%). In addition, 12.4 million adults (95% CI, 12.1-12.7) with missed opportunities had received the influenza vaccine in a clinical setting in 2012, Van Handel and Dietz reported.

"Missed opportunities increased during 2011-2013, varied by state, and occurred among persons who received other clinical preventive care," the authors wrote. "States with high prevalence of undiagnosed HIV especially need to reduce missed opportunities. Education for providers and implementation strategies (eg, clinical protocols) are needed to reduce missed opportunities for HIV screening."

Van Handel told Healio Internal Medicine that the CDC utilizes various methods, including educational campaigns, to address provider awareness.

"The 'HIV Screening. Standard Care.' campaign gives primary care providers new tools and a variety of resources to help ensure all their patients are tested for HIV at least once in their life," she said. "CDC also recently launched the 'Doing It' campaign, which is designed to motivate all adults to get tested for HIV and know their status. The campaign also includes efforts to raise awareness among providers of the importance of testing all people aged 13-64, regardless of risk."

Van Handel also noted that specific implementation strategies can vary greatly across different health care settings.

"One example strategy is to include HIV testing on the routine panel of blood-based laboratory tests, such as was done for women during pregnancy," she said. – by Chelsea Frajerman Pardes

Disclosures: Van Handel reported no relevant financial disclosures.


Van Handel M, Dietz P. Abstract 966. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 22-25, 2016; Boston.