HIV testing in US often performed late

An analysis of data from 34 states suggests that many people still do not undergo HIV testing until late into the course of infection, when treatments may have limited effectiveness.

In a study of subjects who were diagnosed with HIV from 1996 to 2005, researchers from the Centers for Disease Control and Prevention found that 45 percent had a diagnosis of AIDS within 3 years: 38.3 percent within 1 year of their initial HIV diagnosis and another 6.7 percent in the next 2 years.

In a second study, CDC investigators examined HIV testing among high school students by analyzing data from the 2007 Youth Risk Behavior Survey. The results showed that 12.9 percent of students overall and 22.3% of those who had ever had sex had been tested for HIV.

The findings of both studies, which appear in the Morbidity and Mortality Weekly Report, were released to coincide with National HIV Testing Day - June 27, 2009.

Late HIV diagnosis was more common in racial/ethnic minorities than in whites. Among subjects newly diagnosed with HIV, those from minority groups were more likely to progress to AIDS in the next 3 years. Men and subjects diagnosed with HIV at an older age were also more likely to progress to AIDS within 3 years.

“To reduce late testing for HIV infection, health-care providers should fully implement both routine and risk-based HIV testing, and local public health officials should continue educational efforts regarding the importance of early HIV testing,” CDC researchers emphasize.

In the high school study, female gender, black race, and having sex before age 13 were all predictive of undergoing HIV testing. Testing also increased as grade level increased. Thus, black, sexually active, females in 12th grade had the highest testing rate: 49.4 percent.

“Health-care providers, educators, and parents or guardians play critical roles in providing support and guidance to adolescents in making decisions about the timing and frequency of HIV testing. Because adolescents might be sexually active but unwilling to discuss this information, health-care providers should provide HIV testing routinely to all patients aged older than 13 years in accordance with CDC recommendations,” the report concludes.

SOURCE: Morbidity and Mortality Weekly Report, June 25, 2009.

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