To The Editor: 

Human immunodeficiency virus (HIV) continues to be a prevalent condition in the US population. According to the US Centers for Disease Control and Prevention, more than 1.1 million people in the United States have HIV, approximately 18% of whom are unaware of their condition.¹ To help combat HIV, the United States Preventive Services Task Force (USPSTF) recently updated its recommendations regarding HIV screening. 

In the previous recommendations from 2005,² the USPSTF strongly recommended HIV screening in “all adolescents and adults at increased risk for HIV infection,” as well as in all pregnant women. The new recommendation ratifies these previous recommendations and enlarges their scope. 

The new recommendations,³ which were published in April 2013, state that all adolescents and adults aged 15 to 65 years be screened for HIV infection. As noted in the new guidelines,³ adolescents younger than 15 years and adults older than 65 years should be screened if they are at increased risk for the infection. Additionally, the new recommendation states that “all pregnant women, including those who present in labor,” should be screened for HIV if their HIV status is not known.^3(p1) 

Although optimum screening intervals have yet to be determined, the USPSTF currently recommends that people between the ages of 15 and 65 years be tested for HIV at least once, while individuals at increased risk should be tested more often (eg, every 3 to 5 years).³ The USPSTF further recommends that individuals at very high risk for HIV infection be tested at least annually.³ 

Using new evidence from studies that have taken place since 2005, the USPSTF substantiated its conclusions, specifically that “expanded HIV screening could identify a substantial number of persons with previously undiagnosed HIV infection, many of whom could benefit from the initiation of ART [antiretroviral therapy], behavioral counseling, and other interventions.”^3(p8) The recommendation relied on “new evidence that initiation of ART in HIV-infected persons with CD4 counts of less than 0.500 × 10⁹ cells/L could improve clinical outcomes and reduce sexual transmission [of HIV].”^3(p8) 

Visit http://www.uspreventiveservicestaskforce.org for more information regarding these recommendations.