Posted on 02/09/2005 2:48:54 PM PST by Southside_Chicago_Republican
Urging a major shift in U.S. policy, some health experts are recommending that virtually all Americans be tested routinely for the AIDS virus, much as they are for cancer and other diseases.
Since the early years of the AIDS epidemic in the 1980s, the government has recommended screening only in big cities, where AIDS rates are high, and among members of high-risk groups, such as gay men and drug addicts.
But two large, federally funded studies found that the cost of routinely testing and treating nearly all adults would be outweighed by a reduction in new infections and the opportunity to start patients on drug cocktails early, when they work best.
"Given the availability of effective therapy and preventive measures, it is possible to improve care and perhaps influence the course of the epidemic through widespread, effective and cost-effective screening," Dr. Samuel A. Bozzette wrote in an editorial accompanying the studies, which appear in Thursday's New England Journal of Medicine .
A failure to institute such screening at doctors' offices and clinics would be "a critical disservice" to patients with the AIDS virus and "the future health of the nation," wrote Bozzette, who is from the University of California at San Diego and the Rand Corp. think tank in Santa Monica, Calif.
Dr. Robert Janssen, director of HIV --AIDS prevention at the Centers for Disease Control and Prevention, said the CDC will re-evaluate its guidelines over the next two years, and will consider the study's findings as well as the availability of new, rapid HIV tests that produce results in a half-hour instead of the usual week or two.
Who would bear the cost of expanded testing — and the cost of the treatment, which runs to at least $15,000 a year — remains a sticky question amid government cutbacks in health-care funding. However, Janssen said the studies' findings could lead to some private insurers to encourage more HIV testing.
One of the studies, by researchers at Duke and Stanford universities and the Veterans Affairs Palo Alto Health Care System, estimated that routine one-time testing of everyone would cut new infections each year by just over 20 percent, and that every HIV-infected patient identified would gain an average of 1 1/2 years of life.
The other study, by Yale and Harvard researchers, found that testing people every three to five years would be cost-effective for all but the lowest-risk people, such as those who are celibate or are in monogamous heterosexual relationships. And even for those people, one-time testing was found to be cost-effective.
Nationwide, about 40,000 new HIV infections occur each year. An estimated 950,000 people are infected with the virus, but about 280,000 of them don't know it.
CDC guidelines recommend routine tests wherever the prevalence of HIV infection is more than 1 percent — basically, cities and some densely populated suburbs.
"If you need proof of the fact that it's not working, look at all the people who have slipped through the cracks — 280,000," said A. David Paltiel of the Yale School of Medicine's division of health policy, lead author of the second study.
The VA-funded study found that in areas where about 1 in 100 patients has undiagnosed HIV — what the CDC calls high-risk settings — widespread testing would cost about $15,100 for each year of good health gained by people diagnosed with the virus, counting the benefits to their sexual partners.
Even in areas with an undiagnosed HIV infection rate of only 1 in 2,000_ the rate in the general population — each healthy year gained by newly diagnosed HIV patients and their partners would still cost less than $50,000. That is the threshold at which health economists generally consider treatments to be cost-effective.
Paltiel noted the two groups of researchers had very similar cost-benefit results, even though they used different computer models.
"The cost-benefit to individuals and society is worth" widespread screening, said Dr. Lawrence Deyton, chief of public health in the Department of Veterans Affairs (news - web sites), which provides medical care to about 5 million veterans.
In light of the findings, he said the VA is going to urge more patients to get tested.
"We're going to take the ball and run with it," Deyton said.
I think you're right about that. HIV is NOT a "mainstream" virus, but apparently some would like everyone to regard it that way.
Don't they test your blood and notify you if you have aids when you give blood?
Just another push to expand the AIDS empire.
Suppose they find more people who are infected with AIDS? What do they propose to do about it? It's illegal to tell anyone or warn the spouse or people they have had sexual contacts with. It's illegal to do anything to hinder people from spreading it.
So they will give these people AIDS drugs? The only thing that has done is to keep HIV positive people alive longer so they can infect more victims. Condoms too do little to prevent the spread of AIDS.
So what's the point? Obviously, more government money would flow to the designated AIDS organizations, who do little or nothing to solve the medical problem but are pretty successful at making AIDS a political icon and tax magnet.
Don't these idiots understand that they as medical/public health leaders cannot afford to lose credibility?
When all you have is a hammer, everthing looks like a nail.
The know exactly what you are stating. What they fear is that the general public will again realize that sexual behavior (homosexual behavior) is the primary transmission.
What the homo-advocates fear is that if the PERCEPTION focuses on homosexual conduct rather than such GENERAL conduct, the public will simple move to telling homosexual to stop they damaging behavior. (homosexual behavior)
heart disease and cancer kill over 1 million people per year, aids about 10,000 per year.
If we test for anything it should be for cancer and heart disease, not HIV.
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