The AAFP supports the United States Preventive Services Task Force (USPSTF) recommendation that clinicians screen adolescents and adults ages 15 to 65 years for HIV infection. Younger adolescents and older adults who are at increased risk should also be screened.
The evidence base for the new recommendation for HIV screening for adults is solid. However, the prevalence of HIV infection and rate of new infection are very low among individuals who are 13-14 and 15-17 years old. Although HIV testing has excellent sensitivity and specificity, the false positive rate will be higher in these populations. The benefits of detecting HIV in a low risk 15-17-year-old versus detecting the infection in the same adolescent at age 18 is unknown, but this detection may reduce further infections. (2019)
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The AAFP suports the USPSTF recommendation that clinicians screen all pregnant persons, including those who present in labor or at delivery whose HIV status is unknown. (2019)
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These recommendations are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute for the individual judgment brought to each clinical situation by the patient's family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These recommendations are only one element in the complex process of improving the health of America. To be effective, the recommendations must be implemented.