HIV screening

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Clinical practice guidelines conflict on which populations should be screened for Human Immunodeficiency Virus Type 1 with the HIV test. The conflict is whether the underlying prevalence of Human Immunodeficiency Virus to justify screening is 1% or 0.2%.

The Centers for Disease Control states:[1]

"HIV screening is recommended for patients in all health-care settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening)"
"Routine, rapid HIV testing is recommended for all adults except in settings where there is evidence that the prevalence of undiagnosed HIV infection is below 0.2%."

The U.S. Preventive Services Task Force states:[2]

"strongly recommends that clinicians screen for HIV all adolescents and adults at increased risk for HIV infection". Regarding the definition of increased risk, the Task Force states "High-prevalence settings are defined by the Centers for Disease Control and Prevention (CDC) as those known to have a 1% or greater prevalence of infection "[2]

A subsequent cost-benefit analysis supported the threshold of 0.2%.[3]

Human rights

The UNAIDS/WHO policy statement on HIV Testing states that conditions under which people undergo HIV testing must be anchored in a human rights approach which pays due respect to ethical principles.[4] According to these principles, the conduct of HIV testing of individuals must be:


  1. Branson BM, Handsfield HH, Lampe MA, et al (2006). "Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control 55 (RR-14): 1–17; quiz CE1–4. PMID 16988643[e]
  2. 2.0 2.1 US Preventive Services Task Force (2005). "Screening for HIV: recommendation statement". Ann. Intern. Med. 143 (1): 32–7. PMID 15998753[e]
  3. Paltiel AD, Walensky RP, Schackman BR, et al (2006). "Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs". Ann. Intern. Med. 145 (11): 797–806. PMID 17146064[e]
  4. UNAIDS/WHO policy statement on HIV Testing (PDF), accessed 5 Oct 2006.