MMWR Morb Mortal Wkly Rep. 2018 Jun 22;67(24):677-681. doi: 10.15585/mmwr.mm6724a2.
Since 2006, CDC has recommended routine screening of all persons aged 13-64 years for human immunodeficiency virus (HIV) and at least annual rescreening of persons at higher risk (1). However, national surveillance data indicate that many persons at higher risk for HIV infection are not screened annually, and delays in diagnosis persist (2). CDC analyzed 2006-2016 data from the General Social Survey (GSS)* and estimated that only 39.6% of noninstitutionalized U.S. adults had ever tested for HIV. Among persons ever tested, the estimated median interval since last test was 1,080 days or almost 3 years. Only 62.2% of persons who reported HIV-related risk behaviors in the past 12 months were ever tested for HIV, and the median interval since last test in this group was 512 days (1.4 years). The percentage of persons ever tested and the interval since last test remained largely unchanged during 2006-2016. More frequent screening of persons with ongoing HIV risk is needed to achieve full implementation of CDC's screening recommendations and to prevent new infections. Integration of routine screening as standard clinical practice through existing strategies, such as electronic medical record prompts (3), or through new, innovative strategies might be needed to increase repeat screening of persons with ongoing risk.
自 2006 年以来,疾病预防控制中心建议对所有 13-64 岁的人进行常规的艾滋病毒(HIV)筛查,并且对高危人群至少每年进行重新筛查(1)。然而,国家监测数据表明,许多有感染艾滋病毒风险的人没有每年接受筛查,而且诊断的延误仍然存在(2)。疾病预防控制中心分析了 2006 年至 2016 年期间来自一般社会调查(GSS)的数据*,估计只有 39.6%的非住院美国成年人曾接受过艾滋病毒检测。在曾经接受过检测的人中,估计上次检测后中位数的间隔时间为 1080 天,即近 3 年。在过去 12 个月中报告存在艾滋病毒相关风险行为的人中,只有 62.2%的人曾接受过艾滋病毒检测,而在这一组中,上次检测后的中位数间隔时间为 512 天(1.4 年)。在 2006 年至 2016 年期间,曾接受过检测的人数和上次检测后的间隔时间基本保持不变。需要更频繁地对持续存在艾滋病毒风险的人进行筛查,以全面实施疾病预防控制中心的筛查建议并预防新的感染。通过现有的策略,如电子病历提示(3),或者通过新的创新策略,将常规筛查纳入标准临床实践,可能需要增加对持续存在风险的人的重复筛查。