Updated draft recommendations from the U.S. Preventive Services Task Force support universal HIV screening in adolescents and adults, as well as preexposure prophylaxis (PrEP) with effective antiretroviral therapy for individuals at high risk of HIV acquisition.
"It is important that clinicians ask their patients about their sexual history and about the use of injection drugs to identify people at risk for HIV, "said Dr. Seth Landefeld of the University of Alabama at Birmingham School of Medicine, a member of the task force.
"For Patients WHO May be at risk for HIV, clinicians Should ask for additional questions to figure out That person's level of risk and discuss PrEP if the person is at high risk, When taken as prescribed, PrEP is very effective at Preventing HIV infection," he told Reuters Health by email.
In the first draft statement, USPSTF recommends that clinicians screen for HIV infection in adolescents and adults aged 15 to 65 years, as well as younger adolescents and older adults who are at increased risk for infection. Pregnant women should also be screened for HIV infection, including those who presented at work or at delivery whose HIV status is unknown.
These recommendations arebasedHIV infection reduces the risk forAIDS-related events or death, decreases the risk for HIV transmission to uninfected sex partners and reduces the rate of mother-to-child transmission. The group found insufficient evidence to identify optimal time intervals or strategies for repeat HIV screening.
All sexually active adolescents and all adults at increased risk for sexually transmitted infections could also benefit from intensive behavioural counselling, according to the draft statement. In the second draft statement, USPSTF recommends that clinicians offer PrEP with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.
Dr. Landefeld highlighted several behaviors and factors that can put people at high risk for HIV, including: Having a sex partner who is HIV positive; having sex without a condom with a partner whose HIV status is unknown and who is at high risk for HIV; recently having a sexually transmitted infection; sharing drug injection needles and syringes; and exchanging sex for money or drugs.
Benefits from PrEP
"PrEP helps prevent HIV, but not other sexually transmitted infections," Dr. Landefeld cautioned. "People who take PrEP should continue to use condoms and practice other behaviors to reduce the risk of contracting another sexually transmitted infection."
"Providers are essential to PrEP implementation , but many lack familiarity with PrEP and face challenges in identifying patients at risk of HIV acquisition," said Dr. Marcus, who was not involved in the USPSTF's work.
"These recommendations from the USPSTF would put PrEP on the radar of primary care providers across the US, but if we are going to scale up PrEP in primary care, we will need to develop effective and equitable HIV risk prediction tools to support providers in identifying patients who may benefit from PrEP. "