Of the estimated 1.1 million Americans infected with HIV, approximately 232,000 do not know they have the virus, reports the Centers for Disease Control and Prevention (CDC). HIV testing remains a keystone activity in the effort to provide health care for those afflicted with the illness and control the HIV/AIDS epidemic. The effects of HIV testing touch both the individual and the community.
Identification of Latent HIV Infection
After infection with HIV, patients enter a prolonged phase of the illness known as clinical latency. During this period, which typically lasts for several years, the patient has no obvious symptoms of disease, explains the medical reference text "Principles and Practice of Infectious Diseases." Diagnosing patients during the latent phase of HIV/AIDS is an important effect of routine HIV testing. Early diagnosis provides patients with knowledge to make informed decisions about their health care before the illness reaches a life-threatening stage.
Opportunity for Early Treatment
The December 2009 "Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents" issued by the U.S. Department of Health and Human Services states treatment of HIV-infected patients before the development of AIDS prolongs survival. HIV testing, therefore, can potentially prolong the life of an asymptomatic HIV-infected patient by providing an opportunity for early treatment.
The DHHS treatment guidelines further note that antiretroviral drug therapy reduces the likelihood of HIV transmission to others due to a treatment-related reduction in the circulating level of the virus. Thus, HIV testing leading to antiretroviral treatment can potentially diminish the rate of HIV transmission in the community by reducing patients' infectiousness.
Risk Reduction
People who learn they have HIV often exhibit behavioral changes that reduce the risk of transmitting the virus to others. In an August 2005 study published in the "Journal of Acquired Immunodeficiency Syndrome," epidemiologist Gary Marks, Ph.D., of the CDC reports a 53 to 68 percent reduction in high-risk sexual behavior after patients learn they have HIV. This finding correlates with a June 2006 study published in the journal "AIDS," in which Marks and colleagues report that patients unaware of their HIV infection are approximately 3.5 times more likely to sexually transmit the virus to others, compared to patients who know they have HIV.
Psychological and Social Distress
Although several potentially beneficial effects may stem from HIV testing, the potentially adverse effects of a patient learning he or she has HIV prove substantial. Despite remarkable medical advances in the treatment of HIV/AIDS, the illness remains a lifelong condition, with substantial health-related and social implications for the patient. In a March 2008 article published in the journal "AIDS Patient Care and STDs," Carol L. Galletly, J.D., Ph.D., and colleagues report that an unanticipated HIV diagnosis may lead to a variety of negative effects, including new or increased substance abuse; suicidal thoughts or behaviors; violent acts toward persons held responsible for a patient's infection; loss of social support due to stigmatization; and post-traumatic stress disorder.
References
- Centers for Disease Control and Prevention: HIV/AIDS Basic Statistics
- "Principles and Practice of Infectious Diseases, Sixth Edition"; Gerald L. Mandell, M.D., et al., Editors; 2004
- U.S. Department of Health and Human Services: Guidelines for the Use of Antiretroviral Agents in HIV-1-infected Adults and Adolescents
- "Journal of Acquired Immunodeficiency Syndrome"; Meta-analysis of High-risk Sexual Behavior in Persons Aware and Unaware They are Infected with HIV in the United States: Implications for HIV Prevention Programs; Gary Marks, Ph.D., et al.; August 2005
- "AIDS"; Estimating Sexual Transmission of HIV from Persons Aware and Unaware that They are Infected with the Virus in the USA; Gary Marks, Ph.D., et al.; June 2006
