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Near-universal HIV screening would require 8-fold increase in testing at primary care offices

Quadrupling HIV testing during primary care visits could “achieve high testing coverage by aged 39 years,” and an 8-fold increase could see near-universal coverage, according to data presented by CDC officials at the Conference on Retroviruses and Opportunistic Infections.

Speaking during the conference in Boston, the researchers said young black and Hispanic males visit physician offices less frequently, and as such, HIV testing during these visits are key.

“CDC recommends opt-out HIV testing of persons aged 13 to 64 years,” Karen Hoover, MD, MPH, of the CDC Division of STD Prevention, said in an interview. “Many HIV-positive persons are unaware of their infection, and their health would be optimized if their infection was diagnosed and [antiretroviral therapy] initiated. In addition, ongoing transmission of HIV is reduced in persons with suppressed viral loads.”

To determine the required frequency of HIV testing of males at primary care visits to U.S. physicians to achieve near-universal coverage by those aged 39 years, the researchers examined data from the 2009-2012 National Ambulatory Medical Care Survey and the U.S. Census. They estimated mean figures for annual number of visits by males aged 18 to 39 years, annual visits per person and HIV testing during visits, stratified by age, race and ethnicity, and calculated the probability of an HIV test in a given year.

According to the researchers, males aged 18 to 39 had 58.4 million visits to physician offices, with HIV testing performed at 1.3% of those visits. White males aged 18 to 24 years had 1.3 mean annual visits per person, compared with 0.61 among black males and 0.59 among Hispanic males of the same age. Testing rates during visits were highest among black males aged 18 to 24 years (2.5% of visits) and 25 to 29 years (4.2%), and for Hispanic males aged 18 to 24 years (5.1%) and 25 to 29 years (2.7%), compared with white males aged 18 to 24 years (1.1%) and 25 to 29 years (2%).

In addition, the researchers found that, with the current rate of HIV testing among males aged 18 to 39 years, 27% of white, 43% of black and 32% of Hispanic males would be tested at least once by the age of 39. A 4-fold increase in testing would cover 73% of white, 91% of black and 80% of Hispanic males. An 8-fold increase would cover 93% of white, 99% of black and 97% of Hispanic males.

“An HIV test is also important to identify HIV-negative persons, who if found to be at substantial risk of acquiring an HIV infection, might be offered [pre-exposure prophylaxis] for HIV prevention,” Hoover said. – by Jason Laday

Reference:

Hoover K, et al. Abstract 967. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 22-25, 2016; Boston.

Disclosure: The researchers report no relevant financial disclosures.