HIV Testing: Support for Routine Screening

Abstract

This article discusses the recent evolution of human immunodeficiency virus (HIV) screening recommendations with significantly expanded role for routine HIV testing. After the Centre for Disease Control (CDC) released recommendations for routine screening in 2006, it was anticipated that the United States Preventive Services Task Force (USPSTF), a national body charged with providing evidence-based recommendations for preventive services, would follow shortly. However, they refrained, citing a lack of evidence at the time to make such a recommendation, and maintained a recommendation for risk-based screening. Following an analysis of recent literature, in 2013 the USPSTF finally made a recommendation for routine HIV screening on the grounds of new evidence. The recommendations are based on the clinical benefit, the failures of risk-based screening, cost-effectiveness data with reduction in HIV related morbidity/mortality, and lower rates of transmission. This article highlights some of the literature that accounted for the change in recommendations and provides a basic review of HIV testing techniques available to the internists and the recommendations for routine screening of patients.