Draft Research Plan
Draft Research Plan for Human Immunodeficiency Virus (HIV) Infection in Nonpregnant Adolescents and Adults: Screening
This opportunity for public comment expired on March 22, 2017 at 8:00 PM EST
Note: This is a Draft Research Plan. This draft is distributed solely for the purpose of receiving public input. It has not been disseminated otherwise by the USPSTF. The final Research Plan will be used to guide a systematic review of the evidence by researchers at an Evidence-based Practice Center. The resulting Evidence Review will form the basis of the USPSTF Recommendation Statement on this topic.
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.
Draft: Proposed Key Questions to Be Systematically Reviewed
1. What are the benefits of screening for HIV infection in asymptomatic, nonpregnant adolescents and adults on mortality, AIDS and opportunistic infections, quality of life, function, and reduced transmission of HIV and other sexually transmitted diseases?
2. What is the yield (number of new diagnoses per tests performed) of screening for HIV infection at different intervals in asymptomatic, nonpregnant adolescents and adults, and how does the yield of screening vary in different risk groups?
3. What are the harms of screening for HIV infection in asymptomatic, nonpregnant adolescents and adults?
4. What are the effects of earlier versus later initiation of antiretroviral therapy in adolescents and adults with chronic HIV infection on mortality, AIDS and opportunistic infections, quality of life, function, and reduced transmission of HIV and other sexually transmitted diseases?
5. What are the longer-term harms associated with newer antiretroviral therapy regimens?
Draft: Proposed Research Approach
The Proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions (KQs).
||Studies conducted in low- and middle-income countries, unless fair- or good-quality trials from the United States are lacking|
KQs 1–3: Asymptomatic, nonpregnant adolescents and adults age 15 years and olderKQs 4, 5: Adolescents and adults living with HIV
KQs 1, 2: Persons who have known HIV infection, are on dialysis, are posttransplant, have occupational exposure, or have known coinfection with hepatitis C, hepatitis B, or tuberculosis
KQ 3: Same as for KQs 1 and 2, plus persons who are at high risk for HIV infection
KQ 4: Persons who have acute HIV infection, are on dialysis, or are posttransplant; studies limited to persons with known coinfection with hepatitis C, hepatitis B, or tuberculosisKQ 5: Same as for KQ 4, plus persons who are already or previously were taking antiretroviral therapy
KQs 1–3: Rapid or standard HIV testingKQs 4, 5: Antiretroviral therapy regimens
KQs 1, 4:
KQ 2: Number of new diagnoses per number of tests performed
KQ 3: Adverse outcomes associated with antiretroviral therapy, including cardiometabolic outcomes; false-positive results, anxiety, and effects of labeling; and partner discord, abuse, or violenceKQ 5: Adverse outcomes associated with antiretroviral therapy, including cardiometabolic outcomes
KQs 1, 3: HIV screening vs. no screening
KQ 2: Repeat HIV screening vs. one-time screening or screening at one interval vs. another
KQ 4: Initiation of antiretroviral therapy earlier vs. later
KQs 1–3: Randomized, controlled trials and controlled observational studies
KQ 4: Randomized, controlled trials and large controlled observational studiesKQ 5: Randomized, controlled trials and controlled observational studies; will consider treatment series if these types of studies are lacking
|KQ 1: Uncontrolled observational studies|
|Timing||KQ 5: Long-term followup, defined as ≥2 years|
Internet Citation: Draft Research Plan: Human Immunodeficiency Virus (HIV) Infection in Nonpregnant Adolescents and Adults: Screening. U.S. Preventive Services Task Force. February 2017.