Doctors Urge HIV Tests for All Patients Over 13
On World AIDS Day 2008, The American College of Physicians is recommending that all patients over age 13 get tested for the HIV virus which causes AIDS.
The organization, which represents more than 126,000 internists, internal medicine subspecialists, residents, and medical students, says it is issuing the new guideline on World AIDS Day, which is Dec. 1, to raise awareness that the disease and virus that causes it are still wreaking havoc across the globe.
"The purpose of the guideline is to present the available evidence to physicians as a way to help guide their decisions around screening for HIV in their practice," says Amir Qaseem, MD, PhD, senior medical associate in the ACP's Clinical Programs and Quality of Care Department. "ACP recommends that physicians adopt a routine screening policy for HIV and encourage their patients to get tested, regardless of risk factors."
Normally, only at-risk patients are routinely screened for HIV and this new advisement from the ACP hopes to address the fact that 27% of Americans have not yet been diagnosed with the virus, resulting in more than 20,000 new infections per year because the carrier didn't know they were infected to begin with. These are avoidable statistics if HIV blood tests were administered to all patients, and not just at-risk patients. Those at higher risk would continue to receive more regular testing.
Higher-risk groups include men who have had sex with men, men and women who've had unprotected sex with multiple partners, past or present injection drug users, and men and women who trade sex for money or drugs or have sexual partners who do.
Persons at risk also include people whose past or present sexual partners were infected with HIV, were bisexual, or were injection drug users; people treated for STDs, and those with a history of blood transfusion between 1978 and 1985.
The ACP identifies patients who received care in high-risk health care settings which would also warrant priority in screening. These include STD clinics, correctional facilities, homeless shelters, tuberculosis clinics, substance abuse clinics, and clinics serving men who have had sex with men. Adolescent health clinics with a high prevalence of STDs also are considered high-risk settings.
Here in Canada, I have heard from friends who requested an HIV test that doctors have refused because it is a 'waste of resources.' If the doctor thinks the patient isn't at risk, they often won't do the HIV test even if requested by the patient. In one case, a friend of mine had to flat-out demand the test, if only for her own peace of mind, and finally the doctor relented after much argument. Should physicians have the right to refuse HIV tests if they don't 'think' the patient is at risk, or should all patients be screened for HIV regardless of risk factor?