The Problem with Screening Everyone

In 2006, CDC recommended that patients in all health-care settings be tested for HIV. In 2013, the USPSTF followed suit and advised HIV testing for persons 15 to 65 years. However, as basic statistics would dictate, testing low risk population will lead to increased false positivity in test results. The increasing sensitivity of the fourth generation HIV tests can even worsen this. As the HIV testing recommendation above is getting applied by more and more health institutions and public health entities, the problem of high false positivity in low risk population arises. It is a very serious matter for a patient getting told what his/her HIV screening result is (it can be very anxiety-provoking). It is also a serious matter for public health as each positive HIV test can mean new case to investigate for Disease Intervention Specialists (DIS). It is therefore very important that providers explain to the patient the concept of positive predictive value of the test in the setting of low prevalence if the patient is of low risk of having HIV.

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