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Tuesday Nov 27, 2018

Help Patients Know Their HIV Status

HIV infection has killed roughly 35 million people worldwide,(www.who.int) and nearly 37 million people are living with HIV. Although advances in antiretroviral treatment have helped make HIV a manageable chronic disease, too many people are still dying.

[world aids day logo]

In 2017, 940,000 people died of AIDS-related illnesses. This marked a decline from a peak of 1.9 million in 2004.(www.hiv.gov) Globally, the number of new infections has remained consistent, with roughly 1.8 million new infections in 2016 and 2017.(www.avert.org)

It's estimated that 25 percent of those living with HIV worldwide (roughly 9 million people) are undiagnosed. That includes an estimated 162,500 Americans, or 15 percent of U.S. HIV cases.(www.cdc.gov) Among young Americans, more than half of those infected are unaware of their HIV status.

In the United States, roughly 38,500 new infections occur each year. Several factors play a role in the continued spread of this disease, including increasing levels of IV drug use linked to the opioid epidemic, stigma, discrimination, inadequate screening and the reluctance of some clinicians to prescribe pre-exposure prophylaxis (PrEP).

As the 30th anniversary of World AIDS Day approaches on Dec. 1, I am reminded not only of how far we have come but how far we still need to go. Sadly, HIV/AIDS still has a profound impact on our society, especially in minority, rural and underserved communities.

Despite screening recommendations by the CDC, the U.S. Preventive Service Task Force and the AAFP, many HIV-infected patients make numerous visits to health care settings before they are diagnosed. HIV screening and testing is imperative to combating this disease. Specifically, 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, as should pregnant women.

The theme for World Aids Day 2018 is "Know Your Status."(www.unaids.org) This event presents an opportunity for family physicians to have a huge impact by screening patients or referring them for screening. The CDC offers a tool that can help patients find free and low-cost screening by ZIP code.(gettested.cdc.gov)

And remember not only the importance of screening, but also diagnosing, linking patients to care, retention in care and viral suppression. Offering PrEP to those who screen negative but are at increased risk can help combat this disease and make our communities healthier.

World AIDS Day is a time to celebrate our progress, mourn those who have been lost and help our patients know their status.

Ada Stewart, M.D., is a member of the AAFP Board of Directors.

Posted at 01:29PM Nov 27, 2018 by Ada Stewart, M.D.

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