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Make AIDS tests routine

WITH ALL the progress that has been made treating AIDS in the United States, each year 40,000 Americans become infected with the virus that causes the disease. More than half of them acquire the disease from people who are not aware they are carrying HIV. Of the slightly more than 1 million Americans with HIV, about 25 percent do not know they are infected and can infect others. To address this lethal ignorance, the Centers for Disease Control and Prevention has said it will recommend more and broader testing this summer.

Testing that is more routine, especially with the new rapid tests that give results within 20 minutes, would seem an obvious choice. But, going back to the time when an AIDS diagnosis was a virtual death sentence and there was severe stigmatizing of those with the disease, testing was recommended mainly for high - risk groups or in areas with high incidence, and only after pre-test counseling.

The disease still carries considerable stigma, but the drug therapies have made it treatable, tilting the balance in favor of more routine testing. Such screening not only brings infected individuals into treatment at an earlier stage when the disease can more easily be kept at bay, but according to the CDC it also motivates more than half of those who find they are HIV-positive to change their behavior to prevent transmission of the virus. Many doctors and public health officials also believe that more routine testing for the virus will help to reduce the stigma of the disease simply by normalizing the way the healthcare system goes about detecting and treating it.

Last week, at the ninth annual Lemuel Shattuck Hospital HIV Conference at the John F. Kennedy Library and Museum, a Boston University School of Medicine professor reported on a study of testing at Boston Medical Center, which serves an area with a relatively high incidence of AIDS. Dr. Paul R. Skolnik said the study of patients tested on a routine basis between 1999 and 2003 showed that 47 percent of those found to be HIV-positive had been admitted to BMC for conditions unrelated to HIV disease. Without the testing, he said, it is unlikely their condition would have been discovered as early as it was.

Like any screening procedure, routine testing for HIV will result in many negative results. But healthcare specialists say that on a cost-benefit basis , routine HIV testing ranks favorably with screening for diseases like colon cancer. At last week's conference, Dr. Rochelle Scheib of the Shattuck Hospital warned against complacency about HIV when the disease's day-to-day challenges are ``overshadowed by the crisis of the day." The CDC recommendations for broader HIV testing should help ensure that the effort to prevent and treat this disease gets the priority it deserves.

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