Here’s a Nutshell Look at US HIV Preventive Service Task Force Recommendations
By Melinda G. Young
The US Preventive Services Task Force recommends that clinicians screen all pregnant women for HIV infection, as well as continue to screen all adolescents and adults who are at increased risk for infection.
The guidelines, which were updated recently from the 1996 recommendations, made no recommendation for routine screening for HIV among adolescents and adults who are not at increased risk for infection.1
In the past nine years new evidence on screening for HIV has caused the task force to update its recommendations. Previously, the task force had recommended HIV testing only for high-risk pregnant women.
The task force considers a person at increased risk for HIV infection if he or she reports one or more individual risk factors or if the person receives health care in a high-prevalence or high-risk clinical setting. This group includes men who have sex with men (MSM), men and women having unprotected sex with multiple partners, past and present injection drug users, people who exchange sex for money or drugs or are partners with people who do, people who have had HIV-infected, IDU, or MSM sex partners, people treated for sexually-transmitted diseases, and people who request an HIV test.1
The task force’s recommendations explain how the standard of care for preventing HIV transmission in seropositive pregnant women has evolved from monotherapy with zidovudine to combination therapies that start at 14 to 34 weeks gestation and continue through labor. Treatment is augmented with six weeks of neonatal prophylaxis with zidovudine, and avoidance of breastfeeding is recommended.1
New research also demonstrates the benefit of elective cesarean section to reduce vertical transmission, the task force says.
Without interventions, vertical transmission of HIV is between 14% and 25%, while with interventions it is 1% to 2%.1
Reference
- Screening for HIV. U.S. Preventive Services Task Force. July, 2005. http://www.ahrq.gov/clinic/uspstf05/hiv/hivrs.htm.
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