Human Immunodeficiency Virus (HIV)

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HIV Infection, Adolescents and Adults

The AAFP recommends that clinicians screen adolescents and adults ages 18 to 65 years for HIV infection. Younger adolescents and older adults who are at increased risk should also be screened. See the Clinical Considerations for more information about screening intervals. (2013)

(Grade: A recommendation)
Grade Definition:http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf13/hiv/hivfinalrs.htm#consider(www.uspreventiveservicestaskforce.org)

Note: The AAFP’s recommendation differs from the U.S. Preventive Services Task Force (USPSTF) only on the age to initiate routine screening for HIV. The USPSTF(www.uspreventiveservicestaskforce.org) recommends routine screening beginning at age 15 years and the Center for Disease Control and Prevention (CDC) recommends routine screening beginning at age 13 years.

  • The evidence base for the new recommendations for HIV screening for adults is solid. The one difference between the AAFP recommendations and those of the CDC and USPSTF pertains to what age to initiate routine screening. The CDC states age 13 year and the USPSTF recommendation states age 15 years. The AAFP recommends routine screening starting at age 18 years.
  • The prevalence of HIV infection and rate of new infection among 13- 14 year olds and 15-17 year olds are very low. CDC data show for the year 2010 there were 529 AIDS cases and 2,200 HIV cases in the age group 15-19 years. Based on the most recent US census there are close to 4 million adolescents in each cohort year or a total of 20 million in the ages 15-19. A rough calculation of (2729/ 20 million) provides a rate of 1.3/10,000. These data are not seroprevalence data and the actual rates are likely higher. However, these case numbers also include children known to be infected at birth and thus not all are infections contracted in the adolescent years. In addition the rate calculated is for the 5 year group and is likely skewed toward the older ages (18 and 19) and the rates in the 15-17 year olds are probably lower than that calculated.
  • The benefits of detecting HIV in low risk 15-17 year old versus detecting the infection in the same adolescent at age 18 is unknown.

HIV Infection, Pregnant Women

The AAFP recommends that clinicians screen all pregnant women for HIV, including those who present in labor whose HIV status is unknown. See the Clinical Considerations for more information about screening intervals. (2013)

(Grade: A recommendation)
Grade Definition:http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm#post(www.uspreventiveservicestaskforce.org)
Clinical Considerations: http://www.uspreventiveservicestaskforce.org/uspstf13/hiv/hivfinalrs.htm#consider(www.uspreventiveservicestaskforce.org)