Intended for healthcare professionals


Screening for HIV infection

BMJ 2016; 352 doi: (Published 19 January 2016) Cite this as: BMJ 2016;352:i1
  1. Jason S Haukoos, professor of emergency medicine and epidemiology1 2 3,
  2. Sarah E Rowan, assistant professor of medicine4 5
  1. 1Department of Emergency Medicine, Denver Health Medical Center, 777 Bannock Street, Mail Code 0108, Denver, CO, 80204 USA
  2. 2Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
  3. 3Department of Epidemiology, Colorado School of Public Health, Aurora
  4. 4Denver Public Health, Denver
  5. 5Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora
  1. Correspondence to: J S Haukoos Jason.Haukoos{at}

How you ask is a critical part of the process

Worldwide, approximately 37 million people are infected with HIV and approximately 46% of infections remain undiagnosed.1 The proportion of undiagnosed cases is lower in industrialized countries, although the burden of people living with undiagnosed infection remains substantial. For example, approximately 13% of the 1.2 million people living with HIV in the United States do not have a diagnosis.2 Moreover, people without a diagnosis contribute disproportionately to transmission of the virus, accounting for about 30% of HIV transmissions.3

Testing for HIV infection remains a critical first step in a series of interventions aimed at controlling the epidemic.4 People who test positive for HIV can then engage in care and attain viral suppression, which dramatically limits the possibility of forward transmission.5 Besides knowing who should be offered HIV testing, maximizing acceptance when HIV testing is offered is a vital piece of the process and may significantly …

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