Improving Human Immunodeficiency Virus Testing Rates with an Electronic Clinical Reminder

Abstract

Human immunodeficiency virus (HIV) is a major global public health problem. In the United States alone, 1 to 1.18 million people are affected, of whom approximately one quarter are unaware of their diagnosis. In the early stage of the epidemic, when effective therapy was not available, testing for HIV was done primarily to protect the nation’s blood supply. However, with the advent of highly active antiretroviral therapy, HIV is highly treatable, and those infected can live longer. Because more than one third of patients diagnosed with HIV are diagnosed with acquired immunodeficiency syndrome within 1 year after diagnosis, it is likely that many patients are infected for many years before diagnosis. Furthermore, beause approximately 20,000 new infections in the United tates are transmitted by people unaware of their HIV positive tatus, early detection of HIV has the potential to decrease ew infections and prevent complications from advanced disase and has been shown to be cost-effective. The Centers for Disease Control and Prevention recommends offering routine screening for HIV in health care settings for all patients aged 13 to 64 years, unless the prevalence of undiagnosed infection has been documented to be less than 0.1%.