Although record numbers are being tested for HIV in the USA, over 200,000 infected individuals are not aware of their HIV status, and one third of diagnoses are occurring later on during the infection when treatment is less effective. A CDC (Centers for Disease Control and Prevention) MMWR report says increased testing is required, especially among populations where HIV diagnoses occur the most.

HIV (human immunodeficiency virus) has become a major cause of health-care expenditures in the USA, it also burdens the country with considerable morbidity and mortality. For HIV positive individuals to be treated effectively, their infection must be diagnosed early. For diagnosis to occur early on during the disease, HIV testing has to be thorough and nationwide. Early diagnosis also reduces incidences of human-to-human transmission.

Information from the National Health Interview Survey, 2001-2009 was used to work out what proportion of 18 to 64 year-olds got tested for HIV in the USA. National HIV Surveillance System data were gathered to estimate numbers, percentages and HIV/AIDS diagnoses rates, as well as late-HIV infection diagnoses rates. A late diagnosis is one that occurs at least 12 months after infection started.

The researchers found that:

  • 40% of 18 to 64 year olds were at some time tested for HIV from 2001 to 2006. This percentage rose to 45% in 2009.
  • From 2001 to 2004 about 37% of those diagnosed HIV positive were diagnosed after being infected for at least 12 months (late diagnosis). By 2007 the figure dropped to 32.3%.
  • Late diagnoses ranged from 25% to 47.2% in 37 states with mature HIV reporting systems in 2007.
  • 51.2% of HIV diagnoses were among African-Americans in 2008.
  • In 2008, about 55% of transmissions occurred among non-injecting males who claimed to have had male-to-male sexual contact.
  • South and Northeast census regions, as well as the states with the largest populations had the highest AIDS diagnosis rates.

The CDC says that health care providers should widen routine screening to include ALL adults. Population groups with higher HIV incidence, as well as geographical areas where HIV prevalence is higher should be tested more often.

Individuals at high risk, such as gay, bisexual, and other males who have sex with males should undergo testing at least once a year.

Public health authorities should inform their populations about the importance of HIV testing.

The CDC informs that 56,000 new infections are reported in the USA each year, approximately one new one every 9.5 minutes. If left untreated, an HIV positive individual will eventually develop AIDS (acquired immunodeficiency syndrome); usually within ten years. Treatment (antiretroviral therapy) will delay the progression of the disease and the patient will live much longer. However, treatment is much more effective if it starts soon after HIV infection, when no symptoms are present.

An HIV-positive 25-year-old patient who receives good treatment early on will typically live 39 years longer than an HIV-positive patient of the same age who doesn’t get treated properly and promptly.

1.1 million adults and adolescents were thought to be HIV positive in the USA in 2006. Approximately 21% of them did not know about their HIV status.

“Vital Signs: HIV Testing and Diagnosis Among Adults – United States, 2001–2009”
Morbidity and Mortality Weekly Report (MMWR) – CDC

Written by Christian Nordqvist