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Clinical Summary

Human Immunodeficiency Virus (HIV) Infection: Screening

Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

Clinical Summary of U.S. Preventive Services Task Force Recommendation

Population Adolescents and adults aged 15 to 65 years, younger adolescents and older adults at increased risk for infection, and pregnant women
Recommendation Screen for HIV infection.
Grade: A
Risk Assessment Men who have sex with men and active injection drug users are at very high risk for new HIV infection. Other persons at high risk include those who have acquired or request testing for other sexually transmitted infections.

Behavioral risk factors for HIV infection include:

  • Having unprotected vaginal or anal intercourse
  • Having sexual partners who are HIV-infected, bisexual, or injection drug users
  • Exchanging sex for drugs or money

The USPSTF recognizes that the above categories are not mutually exclusive, the degree of sexual risk is on a continuum, and individuals may not be aware of their sexual partners' risk factors for HIV infection.

Screening Tests The conventional serum test for diagnosing HIV infection is repeatedly reactive immunoassay, followed by confirmatory Western blot or immunofluorescent assay. Conventional HIV test results are available within 1 to 2 days from most commercial laboratories.

Rapid HIV testing may use either blood or oral fluid specimens and can provide results in 5 to 40 minutes; however, initial positive results require confirmation with conventional methods.

Other U.S. Food and Drug Administration–approved tests for detection and confirmation of HIV infection include combination tests (for p24 antigen and HIV antibodies) and qualitative HIV-1 RNA.

Interventions At present, there is no cure for chronic HIV infection. However, appropriately timed interventions in HIV-positive persons can reduce risks for clinical progression, complications or death from the disease, and disease transmission. Effective interventions include antiretroviral therapy (ART) (specifically, the use of combined ART), immunizations, and prophylaxis for opportunistic infections.
Balance of Benefits and Harms The net benefit of screening for HIV infection in adolescents, adults, and pregnant women is substantial.
Other Relevant USPSTF Recommendations The USPSTF has made recommendations on behavioral counseling to prevent sexually transmitted infections. This recommendation is available at http://www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org/.

Current as of: April 2013

Internet Citation: Clinical Summary: Human Immunodeficiency Virus (HIV) Infection: Screening. U.S. Preventive Services Task Force. October 2014.
https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/human-immunodeficiency-virus-hiv-infection-screening

USPSTF Program Office   5600 Fishers Lane, Mail Stop 06E53A, Rockville, MD 20857