Screen all at risk for HIV, plus pregnant women

The United States Preventive Services Task Force, updating its 1996 guidelines, now recommends HIV screening for all pregnant women. The Task Force continues to recommend screening all adolescents and adults at risk for HIV.

The new recommendations are published in the July 5, 2005, issue of Annals of Internal Medicine, along with two background papers on which the recommendations are based.

The recommendations will be posted on Web sites of the journal, http://www.annals.org/cgi/content/full/143/1/32 and of the Agency for Health Care Research and Quality http://www.ahrq.gov/clinic/uspstf/uspshivi.htm.

The HIV screening recommendations are also the subject of a video news release produced by the American College of Physicians, publisher of Annals of Internal Medicine. Call for coordinates and a copy of the script.

The Task Force’s earlier recommendations on HIV screening called for routine screening and counseling for high-risk pregnant women and those living in communities with high rates of infected newborns.

“Having a test for HIV during pregnancy is one more thing a woman can to do to try to assure having a healthy infant,” said Diana Petitti, MD, Vice-Chair of the USPSTF and a Senior Scientific Advisor for Health Policy and Medicine for Kaiser Permanente Southern California.

Mother- to- infant transmission is an important and preventable cause of childhood AIDS. Therapy helps the mother (by delaying overt AIDS and opportunistic diseases) and the infant (by decreasing spread of infection from mother to child), Dr. Petitti said.

People considered at risk for HIV report one or more individual risk factors or live or receive health care in an area with a high prevalence of the disease. Individual risk factors include:

* Men who have had sex with men after 1975
* Men and women having unprotected sex with multiple partners
* Past or present injection drug users
* Men and women who exchange sex for money or drugs or have sex partners who do.
* Individuals whose past or present sex partners were HIV infected, bisexual, or injection drug users
* Persons being treated for sexually transmitted diseases (STDs)
* Persons with history of blood transfusion between 1978 and 1985.

The USPSTF is an independent panel of experts in prevention and primary care. The Task Force has no authority to implement or mandate that their recommendations be followed, but many physicians, clinics, insurance companies and professional medical organizations, such as the American College of Physicians, endorse or follow their recommendations.

From American College of Physicians

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