HIV Screening Most Optimal at 25 Years of Age If No Risk Factors

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HIV Screening Most Optimal at 25 Years of Age If No Risk Factors
HIV Screening Most Optimal at 25 Years of Age If No Risk Factors

TUESDAY, Jan. 9, 2018 (HealthDay News) -- For young adults without known risk factors, a one-time routine HIV screen at 25 years would optimize clinical outcomes and be cost-effective, according to a study published in the January issue of the Journal of Adolescent Health.

Anne M. Neilan, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues simulated HIV-uninfected 12-year-olds without identified risk factors who faced age-specific HIV infection risks. The authors modeled a one-time HIV screen ($36) at age 15, 18, 21, 25, or 30 years, each in addition to current U.S. screening practices (30 percent screened by age 24).

The researchers found that all one-time screens detected a small proportion of lifetime infections (0.1 to 10.3 percent). A screen at 25 years led to the most favorable care continuum outcomes at age 25 compared to current screening practices, with a higher proportion diagnosed (77 versus 51 percent), linked to care (71 versus 51 percent), retained in care (68 versus 44 percent), and virologically suppressed (49 versus 32 percent). A screen at age 25 years not only provided the greatest clinical benefit but also was cost-effective ($96,000/year-of-life saved [YLS]) by U.S. standards of <$100,000/YLS compared with the next most effective screen.

"Focusing screening on adolescents and young adults ages 18 or younger is a less efficient use of a one-time screen among AYA than screening at a later age," the authors write.

Abstract/Full Text

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