Better HIV screening worthwhile in U.S., study finds

WASHINGTON Mon Dec 20, 2010 5:11pm EST

<str:truncateNicely lower=A nurse takes blood for an HIV test in this file photo. REUTERS/Luis Galdamez" />

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WASHINGTON (Reuters) - Expanding screening for the AIDS virus to include every American at least once and the highest-risk people once a year could prevent more than 80,000 infections over the next 20 years, researchers projected on Monday.

And if treatment for infected people were integrated into such a program, it would prevent an estimated 212,000 new infections, the team at Yale University in Connecticut and Stanford University in California reported.

The U.S. Centers for Disease Control and Prevention recommends universal screening -- testing everyone at least once for the human immunodeficiency virus that causes AIDS. But little or no funding has gone to such a program.

The CDC estimates that 600,000 Americans have died of AIDS, 1.1 million are infected and 21 percent of those infected do not know it because they have not been tested. More than 56,000 Americans get infected every year with the incurable virus.

Yale's Elisa Long and colleagues at Stanford made several projections for how testing and treatment night affect the epidemic in the United States.

"Our model projects that approximately 1.23 million new HIV infections will occur over 20 years, with 74 percent occurring among high-risk persons," they wrote in their report, published in the Annals of Internal Medicine.

Those at highest risk in the United States include gay and bisexual men, blacks and injecting drug users.

"One-time screening of low-risk persons combined with annual screening of high-risk persons prevents 81,991 infections (6.7 percent of the projected total)," they added.

But a joint strategy that includes screening everyone once in their lives and annual screening of the people at highest risk, plus treatment of 75 percent of those infected, would prevent more than 212,000 infections, or 17 percent of the total, Long's team found.

TREATMENT SYNERGY

"You do the most for health outcomes by scaling up these programs together. They are synergistic," Stanford's Dr. Owens said in a statement.

Such a program would cost $26.9 billion over 20 years, or about $22,000 per quality-adjusted life year saved, an accepted measure that reflects both how long people live and their quality of life.

"We find that expanded screening and treatment could offer substantial health benefits, preventing 15 to 20 percent of new cases," Long said in a statement. "And the strategy of one-time screening of low-risk individuals and annual screening of high-risk individuals is very cost-effective."

Trying to test everyone in the country once a year would be far too expensive, Long's team found -- $750,000 per quality-adjusted life year.

Long's team also looked to see whether testing and treating nearly everyone could eliminate HIV in the United States.

"Such a strategy could prevent 24 percent of new infections but would not prevent more than 40,000 new infections each year," they wrote.

The AIDS virus is carried in blood, semen and breast milk. No vaccine is available and there is no cure, but cocktails of HIV drugs can keep patients healthy for years. There is growing evidence that the drugs may reduce the likelihood that a patient will infect someone else.

And if people know they are infected, they can reduce risky behavior likely to infect others, by using condoms, abstaining from sex, not sharing needles and using HIV drugs.

(Editing by Cynthia Osterman)

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Comments (5)
dsinla wrote:
View the Award winning documentary “House of Numbers” to see why questions about this must be raised, and why deeper issues about HIV and AIDS need to be
discussed. Lives are at risk. This is the first documentary ,with the worlds
foremost authorities, that highlights the fundamental problems with HIV
testing, science, and statistics, It sheds new light on a misunderstood
phenomenon., for which there is still no cure.
GO to http://bit.ly/fhUxaJ – bit.ly/gogKLZ to see the trailer of “House of Numbers”.

Dec 20, 2010 6:00pm EST  --  Report as abuse
gramps wrote:
this is unconstitutional.

Dec 20, 2010 9:58pm EST  --  Report as abuse
dewey0022 wrote:
Until crimilization laws within this country are changed in regard to sexual activity and HIV, how can you expect to raise the testing rates among the people. It really cannot be forced unless the government wants to throw HIPPA laws and other privacy laws out the window, and I also believe there are some constitutional barriers that would have to be overcome. Many state laws are still criminalizing people with HIV for having sex with others while using protection and not passing the disease. Many new drugs on the market make it very hard for HIV positive people to pass the disease because their viral loads go undetectable, yet someone can get 20 years in prison because they didn’t tell another consenting adult that they had sex with that they had the disease even though they didn’t pass it to them. This would make me want to go right out and get test; yeah right!!! Yes prevention can happen if more people were tested and treated, but what 20 year old is going to get tested if he/she knows they will be a criminal the rest of their lives if they test positive and ever have sex with someone (passing or not passing the disease)without disclosing it. Put a fix on the criminalization laws, learn the facts about treatment, and how it reduces the chance of transmission, and maybe, just maybe, we can get more people to test and slow this disease.

Dec 21, 2010 7:12pm EST  --  Report as abuse
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