Late HIV Diagnosis: Bad Medicine and Worse Public Health Perspective
Author Information
Author(s): Ronald O. Valdiserri
Primary Institution: US Department of Veterans Affairs
Hypothesis
How can we configure and sustain health-care systems that are capable of promoting and incentivizing necessary prevention services such as early HIV diagnosis?
Conclusion
Targeted counseling and testing may be more effective than opt-out testing in diagnosing more people with HIV and preventing infections.
Supporting Evidence
- About 40% of persons diagnosed with AIDS had their first positive HIV test less than 12 months before their AIDS diagnosis.
- Annual HIV transmission rates are 3.5 times higher among people with undiagnosed HIV compared to those diagnosed.
- Interactive client-centered counseling can reduce risk behaviors and the incidence of new sexually transmitted infections.
Takeaway
The study suggests that asking people about their HIV status in a more personal way might help find more people who are sick and stop the virus from spreading.
Methodology
Scenario and cost-effectiveness analyses were used to compare targeted counseling and testing with opt-out testing.
Potential Biases
The author has past affiliations with the CDC, which may influence the interpretation of the guidelines discussed.
Limitations
The study does not address all factors influencing late HIV diagnosis and relies on modeling rather than direct observation.
Participant Demographics
The focus is on Americans aged 13-64 years old who are at risk for HIV.
Digital Object Identifier (DOI)
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