PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 2671108

Why mandatory HIV antibody screening cannot work.

R J Wilson
View original source ↗Export metadata ↓

Abstract

In 1985 this country introduced the first serologic screening test [enzyme immunoassays (EIAs)] designed to detect antibodies to the human immunodeficiency virus (HIV), the pathogen of acquired immunodeficiency syndrome (AIDS). Some people now suggest use of this test to identify people within the general population who are infected with the virus. This article will review technical and administrative problems pertaining to the use of EIAs to screen the general population for antibodies to HIV, and will explain why optometrists can provide safe and comprehensive care to all patients without knowledge of a patient's HIV antibody status. Prior knowledge by the optometrist of the patient's serological status is unnecessary if the practitioner 1) adheres to established guidelines pertaining to infection control, and 2) is aware of the various ocular manifestations of HIV disease. It concludes that mandatory HIV screening programs should not be adopted until the benefits to society have been more clearly elucidated and associated technical, administrative, and ethical problems have been resolved.

Explore related subjects

AIDS SerodiagnosisAcquired Immunodeficiency SyndromeConfidentialityEye DiseasesHIV AntibodiesHumansImmunoenzyme TechniquesMass ScreeningPredictive Value of TestsJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

R J Wilson. 1989. Why mandatory HIV antibody screening cannot work.. https://pubmed.ncbi.nlm.nih.gov/2671108/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Can increasing awareness of HIV seropositivity reduce infections by 50% in the United States?

BACKGROUND: In 2003, US Centers for Disease Control and Prevention (CDC) announced an HIV prevention initiative that emphasized increasing the proportion of persons living with HIV who are aware of their positive serostatus. Previously, CDC set a national HIV prevention goal of reducing new infections by 50% by 2005, with increasing serostatus awareness a central goal. The objectives of this article are to examine the national epidemiologic consequences of increasing serostatus awareness and the important question of how far increasing awareness could lead toward achieving CDC's goal of a 50% reduction in incident infections. METHODS: Scenario analysis methods were used to project incident HIV infections over 1- and 10-year time horizons at varying levels of HIV seropositivity awareness. Because HIV transmission rates are several times higher for those who are unaware of their HIV seropositivity than for those who are aware, we modeled the effects of increasing awareness via HIV counseling and testing and moving people from the higher to the lower transmission category. RESULTS: Increasing awareness of HIV seropositivity via HIV counseling and testing in the United States from a baseline 75% to 95% has the potential of reducing new infections by as much as 32% in a single year. Achieving the national goal of 50% reduction seems out of reach, however. CONCLUSIONS: Reduction of new infections by 50% in the United States requires a combination of prevention services to reduce further the already low HIV transmission rate from persons aware of their HIV seropositivity and HIV risk reduction interventions for at-risk persons. Counseling and testing alone seems insufficient to meet the 50% incidence reduction goal.

AIDS Serodiagnosis↗
PubMed2007

Estimating HIV incidence in voluntary counseling and testing clients in Uganda (1992-2003).

OBJECTIVES: To estimate HIV incidence from first-time testers among voluntary counseling and testing (VCT) clients in Uganda. METHODS: Data on 203,000 VCT clients tested from 1992 through 2003 were adjusted for temporal changes in the testing population. Differential mortality rates by HIV status were used to derive expected prevalence at future times from baseline prevalence within 5-year birth cohorts. Incidence was computed as the proportion of HIV-uninfected persons who seroconverted divided by the proportion negative at baseline. RESULTS: Annual HIV incidence per 100 uninfected persons increased from 0.9 (95% confidence interval [CI]: 0.8 to 1.1) in 1993 to 2.3 (95% CI: 2.2 to 2.5) in 2003 (chi test for trend, P < 0.001). Prevalence decreased from 23% to 13% in 1999 to 2000 and increased to 15% in 2003. Women had a higher incidence. Peak incidence shifted to older age groups over time. CONCLUSIONS: Estimating incidence from routine data presents a practical way of tracking HIV incidence and is a useful tool in targeting and evaluating the impact of prevention programs. Our analysis reveals a new phase of the HIV epidemic in Uganda: decreasing prevalence and increasing incidence, especially among middle-aged persons. These findings support the need for intensified prevention interventions among middle-aged persons in Uganda.

AIDS Serodiagnosis↗