The HIV Medicine Association (HIVMA) says it applauds new federal guidelines that will make HIV testing a routine part of medical carean important step to controlling the growing HIV epidemic in the United States. Despite prevention efforts, 40,000 more people are infected with HIV every year.
In guidelines to be released on Sept. 22, the Centers for Disease Control and Prevention (CDC) recommends testing patients in all healthcare settings for HIVfrom primary care doctors' offices to public health clinics to prison hospitals. Patients should be informed of the test, and can opt out.
"We're very happy that CDC is taking this important step," said HIVMA chair Daniel R. Kuritzkes, MD. "We see far too many patients who were never tested for HIV before they became sick with AIDS. Routine testing will help identify more of the 25 percent of people with HIV who don't know they are infected."
"Patients who get treatment while they're still healthy live longer than those who get it when they're already sick," notes HIVMA board member Michael S. Saag, MD. "The costs for providing their care is more than two times lower when treatment is started earlier as well."
The new CDC guidelines are the first step to removing barriers to testing. Until now, testing for HIV has been treated differently than for any other disease, requiring a separate written consent form and extensive counseling on the test, its implications, and HIV risk behavior. The new guidelines suggest that these steps no longer be required in clinical settings.
"Patients go to their doctors expecting to be screened for heart disease, cancer, sexually transmitted diseases, or other conditions," Saag said. "But no one signs a form to get a prostate exam. We need to make sure that patients are informed about the HIV test, but we should not put obstacles in the way of testing."
But testing is just the beginning of a patient's battle with HIV. The next hurdle is access to treatment and expert medical care. Many of those identified are likely to be uninsured or underinsured. "The programs they rely on to provide them with care are already bursting at the seams," Saag said. "Providers are overworked and burning out. Funding is too short to hire more staff, even as the caseload keeps increasing all the time. We're on the brink of a crisis in HIV care in this country."
"Routine HIV testing can save lives. It is the right thing to do," Kuritzkes added. "But Congress absolutely must back up increased testing with funding to match. Now is the time for overburdened HIV-care providers to speak up. Tell Congress to reauthorize and adequately fund the Ryan White CARE Act and expand access to Medicaid to ensure that those who are newly identified with HIV receive the care and services they need."
Source: Infectious Diseases Society of America (IDSA)
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