An analysis of a 2006 national health survey by the US Centers for Disease Control and Prevention found that only 40.4 per cent of Americans aged between 18 and 64 reported ever having been tested for HIV, which leaves about 60 per cent who have never been tested. The agency said new strategies are needed to ensure more people are tested as part of routine medical care.
The methods and results of the analysis are in the 8th August issue of the CDC’s Morbidity and Mortality Weekly Report (MMWR) together with an explanation of why it was carried out, which was to establish a baseline for evaluating the recommendations the federal agency made in September 2006 to implement HIV screening as part of routine medical care for all people between 13 and 64 in the US.
The CDC said that diagnosis of human immunodeficiency virus (HIV) infection allows people who are infected to get medical help that can make a significant difference to the quality and length of their lives, and it encourages people to change their habits and stop spreading the virus.
A report presented at the 2005 National HIV Prevention Conference in Atlanta, quoted by the CDC, suggested that about one quarter of the 1 million people living with HIV in the US were not aware they had the virus. Yet, according to a CDC surveillance report in 2006, among those people diagnosed with HIV in the previous year, 38 per cent of them went on to receive a diagnosis of acquired immunodeficiency syndrome (AIDS) within 1 year of their first positive HIV test. That is why the agency recommended that routine screening be introduced, especially for those who might be disproportionately affected by HIV.
This latest analysis is based on data from the National Health Interview Survey (NHIS), an annual survey of a representative cross-section of households that gives prevalence estimates for a wide range of health measures for civilian, noninstitutionalized US adults aged 18 to 64 years living in the 50 states and District of Columbia. The data comes from live interviews with participants, and in 2006 the response rate was 71 per cent.
The analysis showed that HIV testing prevalence more or less reached a plateau between 2001 and 2006, and in 2006, 40.4 per cent of adults aged 18 to 64 (nearly 72 million people), said in their interview that they had been tested at least once for HIV infection. Also, 10.4 per cent (nearly 18 million people) said they had been tested in the last 12 months, and 23 per cent who acknowledged having at least one risk factor (from a set list) for HIV said they had been tested in the last 12 months.
The results of the analysis can’t be compared with previous reports because it used a different way of treating respondents with missing data.
Looking back to 1987, the percentage of people in the US ever tested for HIV was 6.0 per cent, and this climbed to 38 per cent in 1997, and then went from 36.4 to 38.4 per cent during 1998 to 2000. Since 2001 the rates have stayed roughly the same, at around 40 per cent.
An accompanying editorial to the report suggests that when this report and other data not published by the CDC are put together, there appear to be several years before the mid 1990s when HIV testing appeared to be rising, then progress stalled in the mid to late 1990s, and now new strategies are needed to bring more people into the loop, particularly those who do not have ready access to health care.
“Persons Tested for HIV — United States, 2006.”
D Duran, J Beltrami, R Stein, A Voetsch, B Branson, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR).
August 8, 2008 / 57(31); 845-849
Sources: CDC.
Written by: Catharine Paddock, PhD