Everybody needs an HIV test, at least once.
That's the verdict from the U.S. Preventive Services Task Force, which has just joined the Centers for Disease Control and Prevention and a scrum of professional medical societies in calling for universal testing for the virus that causes AIDS.
Teenagers and adults (ages 15 to 65) should get screened for HIV, the guidelines say, with retesting at least once a year for people at higher risk of infection, including men who have sex with men and people who use IV drugs.
The task force also recommends that women in labor be tested for HIV if they don't know their status.
The independent group, which evaluates tests and treatments by weighing risks and harms, shied away from recommending universal testing back in 2005 because it saw risks in the side effects of treatment.
But with treatments becoming more powerful and safe, turning AIDS into a chronic disease rather than a death sentence, the panel decided that universal screening will help people get into treatment faster, and thus help reduce spread of the virus.
About 50,000 people become infected in the United States each year.
Right now, 20 to 25 percent of the Americans who are infected with HIV don't know it, according to the task force. The percentage is much higher among teenagers and young adults — about 60 percent.
"We would hope to capture people who either weren't aware that they were at increased risk or preferred not to disclose that," says Dr. Douglas Owens, director of the Center For Health Policy at Stanford University.
That includes women, Owens says, since most women who get AIDS in the United States are infected through heterosexual sex. Owens says: "We're trying to identify everyone who has HIV, irrespective of risk behaviors."
Everyone in that 15 to 65 age group should be tested at least once, the USPSTF says, but after that the advice gets more complicated. "The evidence makes it challenging to say it ought to be this often, Owens told Shots.
The guideline was published in Annals of Internal Medicine.
The CDC recommends that people with risk factors including multiple sex partners, IV drug use, and men having sex with men get tested at least once a year, and perhaps more. "That is reasonable," Owens says. "If you are at ongoing risk, if you have new sexual partners, periodically it would make sense to get screened."