National HIV Testing Day: High-risk patients not screened frequently enough

Today is National HIV Testing Day, which the CDC recognizes each year on June 27 to promote the importance of detecting, testing and preventing HIV. Since 2006, the CDC has recommended one-time screening for all patients aged 13 to 64 years and screening at least once a year for high-risk patients. However, data published recently in MMWR show HIV testing intervals often exceed 1 year among high-risk groups, and that many of these patients have never been tested.

“Findings from this analysis suggest that HIV screening frequency for persons with recent HIV risk is suboptimal and has not improved substantially since 2006,” Marc A. Pitasi, MPH, epidemiologist in the CDC’s Division of HIV/AIDS Prevention, and colleagues wrote. “Continuing efforts are needed to achieve full implementation of annual screening recommendations and prevent new infections.”

Previous findings demonstrating low compliance with HIV testing among high-risk populations were based on limited surveillance data and are not generalizable to the rest of the U.S. population, Pitasi and colleagues said. To determine the frequency of HIV testing in other populations, they assessed data from the General Social Survey. Their analysis included information on adults in the United States who participated in the survey between 2006 and 2016.

Of the 15,956 respondents, 11,688 completed questions regarding HIV-related risk behaviors and testing. Among them, 39.6% said they were ever tested for HIV. The average time since the last test was approximately 3 years (n = 1,080 days).

Nearly 1,700 participants said they participated in HIV-related risk behaviors in the past year. Of these patients, only 62.2% were ever tested for HIV, and they reported that their last test was, on average, 1.4 years, or 512 days, ago.

In light of these findings, Pitasi and colleagues said it will be important for health care providers and public health practitioners to strengthen efforts that aim to identify and routinely screen patients at high risk for HIV.

Eugene McCray

“Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3 to 6 months),” Eugene McCray, MD, director of the CDC’s Division of HIV/AIDS Prevention, told Infectious Disease News. “HIV testing of people with ongoing HIV risk and widespread implementation of routine HIV testing for all adults and adolescents is needed to diagnose HIV infection sooner, improve the health of people with HIV, and prevent new infections.”

To mark the occasion of National HIV Testing Day, Infectious Disease News has compiled a list of the top 10 stories about HIV testing over the past year. – by Stephanie Viguers

Many high-risk patients report not being tested for HIV at clinical visit

About half of men who have sex with men and people who inject drugs in the U.S. who were unaware of their HIV infection reported not being offered testing in the past year even though they had visited a clinician, according data published in JAMA. Read more.

Transgender HIV testing rate about half that of gay, bisexual men

Although transgender people are at high risk for HIV infection, they reported testing for the virus at just over half the rate reported by gay and bisexual men in recent surveys. CDC researchers said the wide disparity calls for enhanced outreach to transgender women and men. Read more.

PCPs often prescribe PrEP before ordering HIV testing

Primary care providers in San Francisco did not order HIV testing for nearly one-quarter of patients starting pre-exposure prophylaxis, or PrEP, according to findings published in Open Forum Infectious Diseases.

Susan Buchbinder, MD, director of Bridge HIV, San Francisco Department of Public Health, and colleagues also reported that many providers failed to comply with CDC recommendations to test PrEP users for HIV every 3 months and sexually transmitted infections (STIs) at least every 6 months. Read more.

Primary care HIV screening cost effective, life-saving

A study published in the Lancet HIV showed that HIV testing at primary care facilities during registration of new patients is cost effective and saves lives through timely diagnosis. Researchers urged health authorities to invest in screening in all municipalities with high HIV prevalence in England, where the study was conducted. Read more.

Rapid, point-of-care HIV test receives WHO Prequalification

Last July, WHO prequalified the OraQuick HIV Self-Test, a point-of-care test developed by OraSure Technologies, Inc. that detects HIV-1 and HIV-2 antibodies within 20 minutes. Read more.

Time from HIV infection to diagnosis cut by 17% in US

The average time between HIV infection and diagnosis decreased 17% in the U.S. from 3 years and 7 months in 2011 to 3 years in 2015, according to CDC data. However, delays in HIV diagnosis continue to be substantial in certain populations, and about a quarter of all people living with HIV go undiagnosed for 7 years or longer. Read more.

HIV testing in South African ED reveals high burden of undiagnosed infections

Study results published in PLoS One showed an HIV testing strategy implemented in an ED in South Africa identified 115 new infections in 3 months. Researchers said their study demonstrates the potential of the testing strategy to detect cases that are missed by clinic-based screening programs. Read more.

Confirmatory HIV testing prevents unnecessary treatment in infants

The use of a second, confirmatory HIV test for infants in South Africa can reduce the number of false-positive results from 128 to 1 per 1,000 infants and is able to save costs related to unneeded treatment, researchers reported. Read more.

Study indicates more transgender women than men take HIV tests

Preliminary findings from a small study in Western New York indicate that transgender women take more HIV tests than transgender men.

Among 27 urban transgender adults included in the study, those who identified as female reported taking more than three times as many HIV tests than those who identified as male, according to researchers. Read more.

Nearly 40% of HIV-positive children in Zimbabwe remain undiagnosed

HIV testing through local clinics failed to diagnose more than one-third of HIV-positive children in Zimbabwe, highlighting the need for community-based approaches to reach the UNAIDS goal of diagnosing 90% of children and adolescents living with HIV by 2020. Read more.

Reference:

Pitasi MA, et al. MMWR Morb Mortal Wkly Rep. 2018;doi:10.15585/mmwr.mm6724a2.

Disclosures: The authors report no relevant financial disclosures.