NCSC Delegates Adopt Proposal Calling for Routine HIV Screening in Teens, Young Adults

The AAFP's National Conference of Special Constituencies, or NCSC, approved several public health-related resolutions during its April 23-25 meeting here, including a proposal that would broadly expand the AAFP's current recommendations for HIV screening.

Specifically, delegates adopted a proposal that calls for the Academy to revise its policy statement on HIV screening to inform members that risk-based screening fails to identify a significant number of people infected with HIV and to encourage routine screening for all patients ages 13 and older, regardless of whether HIV risk factors are present. The delegates further directed that the proposal be submitted to the AAFP Congress of Delegates.

Lillian Wu, M.D., a gay, lesbian, bisexual and transgender constituency representative from Renton, Wash., and co-author of the resolution, testified during a hearing of the Reference Committee on the Health of the Public & Science that joint guidelines from the American College of Physicians and the HIV Medicine Association recommend screening in communities where it is known that the infection rate is one in 1,000 or higher.

Wu said the prevalence of HIV infection is unknown in many U.S. communities, but nationally, it is estimated that four in every 1,000 Americans are infected.

Douglas Gruenbacher, M.D., the new physician representative from Quinter, Kan., agreed that routine screening is needed in some communities, but he opposed the resolution, saying that routine screening of patients ages 13 and older would be unreasonable and would not be cost-effective in some areas, including his small farming community in western Kansas.

The Academy's existing HIV screening recommendations and policy statement call for screening for pregnant women and people in certain high-risk groups, but the AAFP currently does not make recommendations for or against routine screening for HIV in patients who are not at increased risk for infection.

Other resolutions that also were adopted and will be submitted to the AAFP Congress are

Delegates also adopted a resolution directing the Academy to provide public education about health risks related to highly caffeinated energy drinks and sugary beverages and to partner with other primary care organizations to develop a position statement on this issue.

An additional proposal that called on the Academy to take a leading role in educating the public about resuscitative or life-prolonging measures and the importance of addressing end-of-life issues was referred to the AAFP's Board of Directors.