University of California-San Francisco, 995 Potrero Ave., San Francisco, CA 94110, USA.
Am Fam Physician. 2009 Dec 15;80(12):1441-4.
An estimated one fourth of persons with human immunodeficiency virus (HIV) are not aware they are infected. Early diagnosis of HIV has the potential to ensure optimal outcomes for infected persons and to limit the spread of the virus. Important barriers to testing among physicians include insufficient time, reimbursement issues, and lack of patient acceptance. Current HIV testing guidelines address many of these barriers by making the testing process more streamlined and less stigmatizing. The opt-out consent process has been shown to improve test acceptance. Formal pretest counseling and written consent are no longer recommended by the Centers for Disease Control and Prevention. Nevertheless, pretest discussions provide an opportunity to give information about HIV, address fears of discrimination, and identify ongoing high-risk activities. With increased HIV screening in the primary care setting, more persons with HIV could be identified earlier, receive timely and appropriate care, and get treatment to prevent clinical progression and transmission.
据估计，四分之一的人类免疫缺陷病毒（HIV）感染者并不知道自己已被感染。早期诊断 HIV 有可能确保感染者获得最佳治疗效果，并限制病毒的传播。医生进行检测的重要障碍包括时间不足、报销问题以及患者接受度低。目前的 HIV 检测指南通过使检测过程更加精简和减少污名化来解决这些障碍。选择退出同意过程已被证明可以提高检测接受度。疾病控制与预防中心不再建议采用默认同意的方式进行检测。尽管如此，检测前的讨论仍然为提供 HIV 相关信息、解决对歧视的恐惧以及识别持续的高风险活动提供了机会。随着初级保健环境中 HIV 筛查的增加，更多的 HIV 感染者可以更早地被发现，获得及时和适当的护理，并接受治疗以预防临床进展和传播。
