U.S. Preventive Services Task Force Expands HIV Testing Recommendations

New recommendations from the task force say that all Americans aged 15 to 64 years should get an HIV test regardless of their risk for contracting the virus.

New draft guidelines from the U.S. Preventive Task Force (USPSTF) recommend that all people aged 15 to 65 years get screened for HIV, even if they are not at an elevated risk of contracting the virus.

Rather than being risk-based, the updated guidelines suggest HIV testing should be a routine endeavor—and under Obama’s health care law, many more people would be eligible to get the test for free at their physician’s office if the guidelines are finalized. Prior to this recommendation, the task force’s guidelines only allowed people at increased risk of infection—such as men who have sex with men or injection drug users—to be eligible for this screening without a copay.

When deciding upon a testing age range, the USPSTF considered the prevalence of sexual activity and sexually transmitted infections among different age groups based on data from the Center for Disease Control and Prevention’s Youth Risk Behavior Surveillance study. They reasoned that an age of 15 years would be a good place to start, noting that “one third of students who are sexually active have engaged in sexual intercourse prior to age 16 years” and “adolescents account for nearly one half of newly acquired sexually transmitted infections.” The age range for routine testing ends at 64 because after 65, the HIV prevalence markedly declines, noted the draft.

Early detection and treatment of HIV is of the upmost importance, the authors wrote. “The USPSTF recognizes that the most effective overall strategy for reduction of HIV-related morbidity and mortality in the United States is primary prevention or avoidance of exposure to HIV infection.”

Besides expanding its prior recommendation to include adolescents and adults ages 15 to 65 years who are not known to be at increased risk for HIV infection, the draft also included new evidence that “initiation of ART in HIV-infected persons with CD4 counts <500 cells/mm³ improves clinical outcomes and reduces sexual transmission.”

This new provision is more in alignment with the CDC’s recommendations from 2006, which recommended routine voluntary screening for HIV in all adults ages 13 to 64 years regardless of other recognized risk factors.

The draft recommendation statement on HIV testing will be available for comment until December 17, 2012, at 5:00 PM ET.