Effective Detection of HIV

Abstract

Summary: Biomedical advances, new HIV testing technologies, and policy shifts in the last 15 years have created substantial new challenges and opportunities for service providers, policy makers, and researchers regarding broad scale identification of HIVseropositive persons. Effective HIV testing will be achieved when we: (1) increase the number of high-risk persons tested; (2) decrease the time from HIV infection to detection; (3) increase testing acceptability; (4) increase the proportion of individuals tested who receive their results; and (5) increase the proportion of individuals tested seropositive who are linked to care. Strategies to enhance effectiveness include implementing new testing technologies and delivery modalities; expanding access to clientcontrolled testing; targeting providers' knowledge, attitudes, and behaviors regarding HIV testing; mainstreaming HIV testing as routine clinical care; targeting persons who engage in high-risk behaviors and those in high-risk groups; and implementing a national behavioral surveillance system. Addressing these challenges will improve HIV detection in the United States, which is vital to both HIV prevention and treatment.

HIV Testing Behaviors Among Female Sex Workers in Southwest China

“…HIV testing may help people who are exposed to the risk of HIV infection know their HIV serostatus in order to have early treatment and prevent transmission to others [1]; HIV testing provides an effective means of secondary prevention, especially for those tested positive [2]. Literature documents the dilemma between high rates of acceptance of testing and low rates of actual testing (including not returning for results) [3].…”

Point-of-Care Testing for HIV: HIV Counselling and Testing

“…They have good user and provider acceptability, and safety. A potential advantage could be that, as more infected individuals learn their status and reduce risk behaviours, HIV transmission will decrease (1,2,12). In 1995, 25% of persons testing HIV positive at American publicly funded clinics did not return for their results (22).…”

“…In terms of occupational safety, there is much less risk of health care worker exposure with finger prick than with venipuncture (24). The need to return for results has previously been identified as one barrier to acceptance of testing (2,23). It has since been shown that sexually transmitted disease and HIV testing clinic clients preferred the convenience of rapid to standard testing (14).…”

“…Data suggest that HIV-infected individuals who are aware of their status are more likely to adopt risk reduction behaviours than those who are not (1). With a diagnosis of HIV, consideration may be given to the initiation of antiretroviral treatment, which reduces viral load and infectivity (2). From a public health perspective, it is advisable to recommend testing to those at risk for HIV and to make testing easily accessible.…”

Fatal Sepsis in an AIDS Patient during Therapy for Pneumocystis carinii Pneumonia

“…Barriers for attending medical care and receiving antiretroviral therapy include lower socioeconomic status, competing subsistence needs, injecting drug abuse and affiliation with a minority group [19][20][21]. To diminish the number of undiagnosed HIV infections, primary care providers should mainstream HIV testing as routine clinical care, especially in high-risk groups [22].…”