NCSC Delegates Adopt Proposal Calling for Routine HIV Screening in Teens, Young Adults
Other Proposals Address Immigrant Care, Minority Population Issues
By David Mitchell
• Kansas City, Mo.
5/6/2009
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.
Delegates to the 2009 National Conference of Special Constituencies recently adopted a resolution that would broadly expand AAFP's 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
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
- a measure calling on the Academy to create a policy that will address immigrant health care, recognize the importance of including immigrants in the patient-centered medical home, and encourage constituent chapters to reach out to their local immigrant communities and invite them to seek preventive care, rather than crisis-driven care;
- a resolution that the AAFP improve its visibility among minority populations by encouraging constituent chapters to partner with community groups that provide social and public services to targeted minority populations; and
- a resolution that the AAFP support medical student and residency education regarding social determinants of health and recognize the role of such factors -- including transportation, access to healthy food, income disparities and education -- in individual, family and community health.
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.
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.
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