l****z
发帖数: 29846 | 1 Health Panel Backs Broad HIV Tests
By THOMAS M. BURTON and BETSY MCKAY
A government health panel on Monday for the first time recommended testing
for the human immunodeficiency virus for all Americans aged 15 to 65, in an
effort to slow its spread.
An estimated 200,000 people in the U.S. are infected with the virus that can
cause AIDS and don't realize it. The U.S. Preventive Services Task Force
said the new draft recommendation is aimed at preventing those people from
infecting others or developing AIDS themselves.
The panel's recommendation is significant because, if finalized, private
insurers would have to pay for the test. Past recommendations haven't always
been embraced by doctors. But in this instance, the weight of medical
evidence has already been trending in favor of screening and earlier
treatment of people with HIV.
It is estimated that 1.1 million Americans have HIV, with about 50,000 new
cases annually.
Focusing tests only on those at high risk hasn't been very effective, the
panel said. "Targeted screening misses a substantial proportion of infected
persons because of undisclosed or unknown risk factors," said an article in
Annals of Internal Medicine published Monday to support the recommendation
to support the task force's recommendation.
Until now, the task force had only recommended that doctors screen all
pregnant women for HIV, and that younger adolescents and older adults who
are at increased risk also be screened. Those at high risk include men who
engage in sex with other men, people who take drugs by injection, and those
who have sex with infected people, the task force has said.
Monday's recommendation doesn't say precisely how often people should get
HIV screening. "One reasonable approach," the task force wrote, "would be
onetime screening of adolescent and adult patients to identify persons who
are already HIV positive, with repeat screening of persons who are known to
be at risk for HIV infections."
Anthony S. Fauci, director of the National Institute of Allergy and
Infectious Diseases and a leading researcher and White House adviser on AIDS
, said more than half of new HIV infections in the U.S. are a result of
people who don't realize they have the virus. Testing and treating people,
he said, "makes it highly unlikely that people with HIV will transmit their
infection to their sexual partners."
Carl Schmid, deputy executive director of The AIDS Institute, a public-
policy advocacy group, called the decision "a monumental shift in how HIV in
the U.S. can be prevented, diagnosed and treated." He called the current
risk-based approach "an ineffective screening strategy."
But there are many people who are skeptical about wider HIV testing, said
Michael S. Lyons, an emergency room physician at the University of
Cincinnati. "The benefits of diagnosing someone as early as possible are
basically proven," he said, "but the difficulty is how do you do that?"
Mr. Lyons said many relatively poor people who show up at the emergency room
may well be HIV-positive, "but emergency departments are very strained at
this point. This is a compelling example of the tension between what would
be good to do and what practically can be done."
The Centers for Disease Control and Prevention declined to comment on the
significance of the recommendation because it is only in draft form and
subject to public comment. Since 2006, the CDC has recommended routine HIV
testing for everyone aged 13 to 64.
From here, the task force's draft would have to become a final
recommendation. At an unspecified time after that, insurance plans would be
obligated to pay for the test. Ultimately, it would be up to doctors to
order the test.
Robert Zirkelbach, spokesman for America's Health Insurance Plans, said, "If
a physician orders a test, the insurer will cover it, and that won't change
." He noted that the Affordable Care Act requires insurers to pick up the
costs.
The HIV tests are either blood or oral-swab tests, and the results of some
are known in minutes. A 2010 study found that the quick test cost on average
$48 for a negative test and $64 for a positive test, with the difference
being the cost of counseling. Jonathan Mermin, director of the CDC's HIV/
AIDS prevention program, has said HIV testing should be "as routine as
cholesterol screening."
Chris Collins, vice president and director of public policy for amfAR, the
Foundation for AIDS Research, said that despite the cost, it's useful to
offer the HIV tests to everyone. "There's clear evidence that, absent
routine testing, people simply aren't offered an HIV test," he said. "Lots
of patients don't feel comfortable talking about this. This needn't be a
highly charged issue."
Write to Thomas M. Burton at t********[email protected] and Betsy McKay at betsy.
m***[email protected] | a**********2
发帖数: 3726 | | w*****s
发帖数: 2896 | 3 这HIV是黑人特多, 同一般普通人关系不是很大, 说白了这又是黑人利益优先, 我们其
实还有更多更重要的地方要花钱.
冥猪党害人呐, 浪费别人的钱不心痛. |
|
