HIV Screening & Prevention: USPSTF Final Recommendations

HIV Screening & Prevention: USPSTF Final Recommendations



my name is Doug Owens I'm a general internist in the chair of the US Preventive Services Task Force the task force is an independent volunteer panel of national experts in disease prevention and evidence-based medicine we work to help Americans live longer and healthier lives by making evidence-based recommendations about clinical preventive services on a variety of topics including HIV and fortunately the HIV epidemic continues to be a very significant public health problem currently almost 40,000 people become infected with HIV in the u.s. each year it's not acceptable and it's a problem we must urgently address the good news is that clinicians have an opportunity to really make a difference in preventing new HIV infections and maintaining the health of those who are living with HIV to help advance these goals the taskforce reviewed the evidence and issued recommendations on HIV screening in HIV prevention for primary care clinicians these recommendations can play a key role in helping end the HIV epidemic in the United States screening for HIV is important so that everyone knows their HIV status people who learn that they have HIV can receive treatment that will dramatically improve their health today's treatments can suppress the HIV virus prevent the progression to AIDS and lower the risk of transmitting HIV to others the test Force recommends screening for everyone between the ages of 15 and 65 and for anyone who is pregnant people younger than 15 or older than 65 who at increased risk for HIV should also be screened clinicians should let their patients know that they recommend HIV screening and discuss what the results might mean and of course screening should only occur if a person has given their permission when a person does not have HIV but is at high risk the Task Force recommends that clinicians offer pre-exposure prophylaxis or prep prep is a medication that substantially reduces the risk of acquiring HIV when taken as prescribed prep is highly effective at preventing HIV infection but prep is not for everyone the best way to decide if prep is right for a person is to ask talk and assess clinician should ask about any injection drug use and talk about a person's sexual history to help determine a person's HIV risk it's important to ask questions such as who they have sex with how many sexual partners they have and what activities they engage in for people whose history shows that they may be at risk for HIV clinicians should ask further questions and discuss the behaviors to help assess their level of risk behaviors that put people at high risk include having a sex partner who is HIV positive having sex without a condom with a partner who is at high risk for HIV sharing drug injection equipment and having sex in exchange for money drugs for housing recently having a sexually transmitted infection also increases a person's risk for HIV prep may be right for people who engage in behaviors that put them at high risk for HIV when a clinician talks to someone about prep there are several important issues to discuss prep needs to be taken as prescribed when it's not it's much less effective people who take prep need to be tested for HIV regularly to confirm that they are HIV negative prep is only for people who do not have HIV it's important that people who take prep continue to use condoms and practice safer sex because prep does not prevent other sexually transmitted infections some people who take prep can experience side effects such as kidney problems or nausea but the benefits of prep far outweigh the risks for anyone who is at high risk for HIV far too many people continue to get HIV we have preventive interventions that work they are highly effective and the evidence is compelling but we know that not enough people receive these interventions HIV screening and HIV prevention with prep reduce rates of HIV infection and can help toward the goal of ending the HIV epidemic in the u.s. so clinicians should screen all patients ages 15 to 65 all pregnant people and anyone at any age who is at increased risk for HIV for those who do not have HIV but are at high risk of getting it clinicians should offer prep following these taskforce recommendations will reduce new HIV infection help people with HIV maintain their health and ultimately save lives

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