HIV & AIDS in the United States Update: HIV Testing Vital Signs

November 28, 2017

Dear Colleagues,

Today, the Centers for Disease Control and Prevention (CDC) released a new Vital Signs on HIV testing and diagnosis delays, which includes:

• A Morbidity and Mortality Weekly Report (MMWR), “Human Immunodeficiency Virus Testing and Diagnosis Delays—United States,” and
• A fact sheet, “HIV Testing: Test Today. Don’t Delay.”

HIV testing has increased in recent years among those at high risk for HIV, leading to fewer people living with undiagnosed HIV in the United States. However, many people have HIV for years before getting a diagnosis of their infection. In 2015, half of the nearly 40,000 people who got an HIV diagnosis had been living with the virus at least 3 years at the time of diagnosis.

Now more than ever, we have the prevention and treatment tools to stop HIV. Prompt diagnosis of HIV is prevention. For people living with HIV, getting a test is the first step to starting antiretroviral therapy (ART), which can preserve their health and prevent HIV transmission to partners. Since approximately 40% of new HIV infections come from people who do not know they are living with HIV, diagnosing HIV quickly and linking people to treatment right away are crucial to achieving further reductions in new HIV infections.

Increased HIV testing—both routine and targeted—is needed to reduce diagnosis delays, improve the health of people living with HIV, and prevent ongoing transmission. CDC recommends routine HIV testing for everyone aged 13-64 and testing at least once a year for people at high risk for HIV. Yet according to CDC data, many people at high risk are not tested annually, including 29% of gay and bisexual men, 42% of people who inject drugs, and 59% of heterosexuals at increased risk.

This Vital Signs shows that there are many missed opportunities to test people at high risk for HIV. A majority of those at high risk who were not tested in the past year saw a provider during that time. Health care providers can play a critical role in reducing diagnosis delays by conducting routine opt-out testing for all patients aged 13-64 and screening all adults and adolescents for HIV risk behaviors to determine who should be tested annually. Look for CDC’s Medscape Expert Commentary, “Increased Routine and Targeted HIV Testing Needed to Reduce Diagnosis Delays,” which will be available on January 15, 2018 and will discuss how providers can increase HIV testing.

It is also important for health departments, community-based organizations, and others who provide HIV testing to expand HIV testing initiatives and help normalize HIV testing for everyone. Please join us for a Vital Signs Town Hall on December 5 at 2:00 PM ET to learn more about how prevention partners are increasing HIV testing in their communities.

We are closer than ever to achieving a future free of HIV in the United States, and we have the prevention and treatment options to get there. But more HIV testing is needed to make sure those powerful tools are available to people who can benefit from them. Please visit the Vital Signs website, learn more about how you can help, and share these materials with your colleagues.

Thank you for the work you are doing to expand HIV testing, prevention, and care. We look forward to continuing our collaborations.

Sincerely,

Eugene McCray

Eugene McCray, MD
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

Jonathan Mermin

Jonathan H. Mermin, MD, MPH
RADM and Assistant Surgeon General, USPHS
Director
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/nchhstp