WASHINGTON (AP) — There’s a new push to make testing for the AIDS virus as common as cholesterol checks.
Americans ages 15 to 64 should get an HIV test at least once — not just people considered at high risk for the virus, an independent panel that sets screening guidelines proposed Monday.
The draft guidelines from the U.S. Preventive Services Task Force are the latest recommendations that aim to make HIV screening simply a routine part of a check-up, something a doctor can order with as little fuss as a cholesterol test or a mammogram.
The proposed changes would expand the HIV testing benefits access requirements in the package of basic preventive services created by the Patient Protection and Affordable Care Act of 2010 (PPACA). PPACA requires non-grandfathered health insurers and health plans to cover the preventive services without imposing co-payments, deductibles, coinsurance percentages or other cost-sharing requirements on the patients.
Since 2006, the Centers for Disease Control and Prevention has pushed for widespread, routine HIV screening.
Not many Americans have heeded that call: Of the more than 1.1 million Americans living with HIV, nearly 1 in 5 — almost 240,000 people — don’t know it. Not only is their own health at risk without treatment, they could unwittingly be spreading the virus to others.
Under the current HIV screening guidelines, only people at increased risk for HIV — which includes gay and bisexual men and injecting drug users — are eligible to get HIV screening without having to worry about insurance plan cost-sharing requirements.
The effort to change the preventive services package guidelines will bring this long-simmering issue before doctors and their patients again — emphasizing that public health experts agree on how important it is to test even people who don’t think they’re at risk, because they could be.
“It allows you to say, ‘This is a recommended test that we believe everybody should have. We’re not singling you out in any way,’” said task force member Dr. Douglas Owens of Stanford University and the Veterans Affairs Palo Alto Health Care System.
There are a number of ways for patients to get tested. If patients are having blood drawn for other exams, the doctor can merely add HIV to the list, with no extra pokes or swabs needed. Today’s rapid tests can cost less than $20 and require just rubbing a swab over the gums, with results ready in as little as 20 minutes. Last summer, the government approved a do-it-yourself at-home version that’s selling for about $40.
Free testing is available through various community programs around the country, including a CDC pilot program in drugstores in 24 cities and rural sites.
Monday’s proposal also recommends:
- Testing people older and younger than 15-64 if they are at increased risk of HIV infection,
- Testing people at very high risk for HIV infection at least annually.
- Testing women once during each pregnancy.
The draft guidelines are open for public comment through Dec. 17.
Most of the 50,000 new HIV infections in the U.S. every year are among gay and bisexual men, followed by heterosexual black women.
“We are not doing as well in America with HIV testing as we would like,” Dr. Jonathan Mermin, CDC’s HIV prevention chief, said Monday.
The CDC recommends at least one routine test for everyone ages 13 to 64, starting two years younger than the task force recommended. That small difference aside, CDC data suggests fewer than half of adults under 65 have been tested.
“It can sometimes be awkward to ask your doctor for an HIV test,” Mermin said — the reason that making it routine during any health care encounter could help.
But even though nearly three-fourths of gay and bisexual men with undiagnosed HIV had visited some sort of health provider in the previous year, 48 percent weren’t tested for HIV, a recent CDC survey found. Emergency rooms are considered a good spot to catch the undiagnosed, after their illnesses and injuries have been treated, but Mermin said only about 2 percent of ER patients known to be at increased risk were tested while there.
Mermin calls that “a tragedy. It’s a missed opportunity.”