Would boost to universal HIV testing initiate an infectious benefit for U.S. public health?

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Faced with 56,000 new HIV infections each year, the CDC proposed in 2006 that HIV testing become part of the routine evaluation that patients would receive unless they opt out — but more than half of America’s high-risk population is still unaware of their HIV status, Reuters reports. About 11 million more Americans have been tested for HIV since the new guidelines took effect, but, according to CDC director Dr. Thomas Frieden, 200,000 remain unaware that they have been infected. Dr. Frieden believes that the increase in first-time HIV testing following the implementation of routine HIV screening “show[s] that progress is possible [but] also show[s] that progress is needed.”

ACSH’s Dr. Elizabeth Whelan, however, questions the cost-effectiveness of a routine HIV testing protocol. “Since HIV is transmitted relatively infrequently heterosexually in this country, perhaps doctors should simply test patients they determine to be at higher risk of contracting the virus. With limited dollars for health care, I’m not so sure that universal HIV screening is money well spent.”

ACSH's Dr. Gilbert Ross, on the other hand, believes that testing a broader population would benefit public health because “many people who have engaged in high-risk behavior, such as men who have unprotected sex with men or intravenous drug users, are not willing to disclose it to their physicians — or their partners, for that matter. Women who are exposed via heterosexual sex may not know it because their partners either do not tell them or don’t know they are HIV-positive. Increasing patient awareness of HIV status could likely initiate safer sex practices, thus reducing the likelihood of HIV transmission and enabling infected patients to receive earlier treatment that could prevent progression to full-blown AIDS.”