HIV Screening for All
A recent study has shown that a more effective way of diagnosing those with HIV is to screen everyone who comes into an ER at random, rather than only offering testing to those who are considered to be at high risk for the disease. Of course, emergency departments are busy enough without adding HIV testing to the mix, but that doesn’t mean it isn’t a good idea for implementation.
Those who defend targeted testing as being the best method will point to its cost-effectiveness by reducing the number of tests performed; it also saves time for ER staff. The problem: People who aren’t considered at risk are far more likely to never think about getting tested. Thus, more can slip through the cracks without ever knowing that they have the disease. This leads to further spread of the virus.
A recent study has made a good case for random HIV screening. The test included nearly 10,000 ER patients. The patients who were screened randomly revealed more HIV-positive individuals than targeted testing. Also, the difference in the number of random tests performed was only slightly more than the number of targeted tests.
While about 60% of the randomly approached patients declined the test (this accounts for the number of patients tested being similar to that of targeted screening), testing on those who consented resulted in 6 individuals learning for the first time that they had HIV. This is crucial so they could begin antiretroviral therapy as soon as possible; it may have also resulted in these 6 individuals being able to take extra precautions so as not to spread the disease.
The verdict is, then, that targeted testing really doesn’t save that much time for ER staff, and it certainly doesn’t catch more undiagnosed cases of the disease. The better method is to implement a more random screening procedure if the staff cannot handle offering the test to every patient.