This is an idea which we should have adopted 20 years ago. Experts Want H.I.V. Testing for All Adults

In what would be a major shift in health policy, some experts are recommending that virtually all Americans be tested routinely for the AIDS virus, much as they are for cancer and other diseases.

Since the early years of the AIDS epidemic in the 1980’s, the government has recommended screening for H.I.V., the virus that causes AIDS, only in big cities, where AIDS rates are high, and among members of high-risk groups, including gay men and drug addicts.

But two large federally financed studies found that the cost of routinely testing nearly all adults would be outweighed by a reduction in new infections and the opportunity to start patients on drug cocktails early, when they work best.

“Given the availability of effective therapy and preventive measures, it is possible to improve care and perhaps influence the course of the epidemic through widespread, effective and cost-effective screening,” Dr. Samuel A. Bozzette, an infectious-disease specialist at the University of California, San Diego, wrote in an editorial accompanying the studies, which appear today in The New England Journal of Medicine.

I do understand why we did not do universal testing in the 1980s. Even then I disagreed. STD programs have decreased the spread of other STDs. Since we can certainly classify HIV as an STD, why should we treat it differently.

I’m sure the ACLU and some activists will decry this stance. They will find fault in the studies (if you are creative enough you can always find fault in studies). But I believe that they are trying to protect a hypothetical individual which putting other individuals at risk.

How can knowing you carry a virus do anything but help you and your contacts? (I do understand the psychological implications if getting a positive test – but that is where good physicians enter the picture).

I have told patients that they were HIV positive. We often deliver “bad news”. HIV positivity, while it decreases ones long term outlook, is not necessarily a death sentence. It will more likely cause serious health problems if the patient and physician are unaware of the positivity.