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Published online 1 December 2008 | Nature | doi:10.1038/news.2008.1266
News: Briefing
Should everyone have an HIV test?
US doctors propose expanding the use of HIV tests to slow the spread of infection.
More than 33 million people around the world are currently living with HIV and AIDS. Strikingly, many adults with HIV or AIDS — about 80% in sub-Saharan Africa and 25% in the United States — don't know that they are carrying the virus.
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To test everyone for HIV/AIDS may initially seem expensive; however, in the long run there is little doubt it would more than pay for itself by alerting the patient that he or she is infected. Future infections could be reduced if not nearly eliminated. Post-diagnosis education would open doors to more responsible safe-sex practices. This potentially could reduce the spread of the lethal virus. Early diagnosis could help the medical community in presently newer and more effective therapies early on thereby improving quality of life and longevity. Research could focus on early detection and track progress of the disease in different age groups, blood types and a host of other physiological considerations. Computational models could more effectively track the trajectories of disease transmission and source clusters. Infected prostitutes, IV drug users and those that continue to practice unsafe sex after being informed they are a carrier could be isolated and reducated as well as getting the medical treatment they require and deserve. It is certain many human right's groups, the ACLU and some mainstream religions would protest such remedies. I would humbly argue that indeed the economic stability of civilization and the well-being of both the non-infected and afflicted outweigh these trivial concerns.
Can I got infected by the testing? I am a little worried about the testing condition such as the case of the blood donor infected by other peopeo who is HIV or somethin like that.
Like Liu yanyan mentioned, when all people above the age of 13 will be tested there is a chance that someone makes a mistake, there for I?ll recommend that this must be done like in a factory, they all must perform the same task, so the chance an error occurs will be very slim.
I would like to raise two points: 1) The modeling by the WHO is based on the assumption that everyone aged 15 and over would be tested annually and given antiretroviral (ARV) therapy - not on the basis of whether it was necessary - but that they would be put on ARV immediately whether it was clinically necessary or not. 2) We published a similar study in The Lancet Infectious Diseases in 2002 (Aug;2(8):487-93) entitled "Could widespread use of combination antiretroviral therapy eradicate HIV epidemics?" by Velasco-Hernandez JX, Gershengorn HB, Blower SM. We also found that it would be possible to eliminate HIV epidemics by using high levels of ARV, but that this would be unlikely to occur if risky behavior increased and drug resistance emerged. The WHO did not account for these 2 factors in their study. Therefore HIV elimination would not be as easy as they suggest.