Re: Annual HIV test

From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Tue Feb 20 15:52:42 2007


http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm

Here's the relevant part from the summary:

Recommendations for Adults and Adolescents

CDC recommends that diagnostic HIV testing and opt-out HIV screening be a part of routine clinical care in all health-care settings while also preserving the patient's option to decline HIV testing and ensuring a provider-patient relationship conducive to optimal clinical and preventive care. The recommendations are intended for providers in all health-care settings, including hospital EDs, urgent-care clinics, inpatient services, STD clinics or other venues offering clinical STD services, tuberculosis (TB) clinics, substance abuse treatment clinics, other public health clinics, community clinics, correctional health-care facilities, and primary care settings. The guidelines address HIV testing in health-care settings only; they do not modify existing guidelines concerning HIV counseling, testing, and referral for persons at high risk for HIV who seek or receive HIV testing in nonclinical settings (e.g., community-based organizations, outreach settings, or mobile vans) (9).

Screening for HIV Infection In all health-care settings, screening for HIV infection should be performed routinely for all patients aged 13--64 years. Health-care providers should initiate screening unless prevalence of undiagnosed HIV infection in their patients has been documented to be <0.1%. In the absence of existing data for HIV prevalence, health-care providers should initiate voluntary HIV screening until they establish that the diagnostic yield is <1 per 1,000 patients screened, at which point such screening is no longer warranted. All patients initiating treatment for TB should be screened routinely for HIV infection (108). All patients seeking treatment for STDs, including all patients attending STD clinics, should be screened routinely for HIV during each visit for a new complaint, regardless of whether the patient is known or suspected to have specific behavior risks for HIV infection.

At Tue, 20 Feb 2007, Garry E. Siegel, M.D. wrote: >
>I thought that it was universal (because 1/4 who are HIV + have no risk
>factor) with the exception if your patient population was very low risk,
>etc.
>
>Garry
>
>At Tue, 20 Feb 2007, art fougner, md wrote:
>>
>>Persons at high risk for HIV infection should be screened for HIV at
>>least annually.
>>http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
>>
>>Annual screening seems to be recommended for High Risk folk. Am I
>>missing something?
>>
>>Art
>>
>>At Tue, 20 Feb 2007, ainsron wrote:
>>>
>>>Ignoring it, except for pregnancy (all patients are requested to have it
>>>drawn, in CA they have to consent to doing it and having the results on
>>>their chart) or in patients I am testing for other STDs or positive for
>>>other STDs
>>>
>>>Ronald E. Ainsworth, MD, FACOG
>>>
>>>-----Original Message-----
>>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E.
>>>Siegel, M.D.
>>>Sent: Tuesday, February 20, 2007 10:15 AM
>>>To: Multiple recipients of list OB-GYN-L
>>>Subject: Gen: Annual HIV test
>>>
>>>With the CDC recommending annual HIV tests across the board from 13 to
>>>65, what are those of us in private practice doing with "routine" annual
>>>exam patients?
>>>
>>>1. Ignoring it.
>>>2. Offering it.
>>>3. Other.
>>>
>>>Garry
>>>
>>>--
>>>Garry E. Siegel, M.D.
>>>Private Practice
>>>Roswell, GA
>>>
>>--
>>art fougner, md
>>"May The Wings of Liberty Never Lose a Feather." - Jack Burton
>>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA




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