What is the recommended frequency for Human Immunodeficiency Virus (HIV) testing in non-high risk individuals?

From the Guidelines

All persons who have ever been sexually active should be tested for HIV at least once in their lives. This recommendation is based on the evidence from the 2018 study published in JAMA 1, which suggests that risk for HIV often changes over a person’s lifetime, and risk evaluation is recommended at each routine clinical visit.

Key Points to Consider

• The testing process typically involves a blood or oral fluid test that detects HIV antibodies and antigens, with results available within minutes to a few days depending on the test type.
• Early detection allows for timely initiation of antiretroviral therapy, which not only preserves immune function and prevents progression to AIDS but also reduces transmission risk to others.
• Regular testing helps normalize HIV screening as part of routine healthcare and reduces stigma associated with testing only in response to high-risk behaviors.

Testing Frequency

• For those with no specific risk factors, testing once is generally sufficient unless circumstances change.
• However, sexually active individuals might consider testing as part of routine healthcare every 3-5 years, even without high-risk behaviors.

Importance of Early Detection

• Approximately 13% of HIV-positive individuals are unaware of their status, highlighting the need for regular testing to identify undiagnosed infections early.
• The USPSTF also recommends routine HIV screening for all adolescents and adults aged 15 to 65 years who are not known to be at increased risk for HIV infection, as stated in the 2013 study published in Annals of Internal Medicine 1.

Additional Recommendations

• The CDC recommends routine voluntary HIV screening in all adolescents and adults aged 13 to 64 years regardless of other recognized risk factors, unless the prevalence of undiagnosed HIV infection has been documented to be less than 0.1% 1.
• Health-care providers should subsequently test all persons likely to be at high risk for HIV at least annually.

From the Research

HIV Testing Frequency in Non-High Risk Individuals

• The recommended frequency for Human Immunodeficiency Virus (HIV) testing in non-high risk individuals is not explicitly stated in the provided studies, as they primarily focus on high-risk groups such as men who have sex with men (MSM) 2.
• However, the CDC's 2006 recommendations suggest that all persons aged 13-64 years should be screened for HIV at least once 2.
• There is no specific guidance on the frequency of HIV testing for non-high risk individuals, but it can be inferred that a one-time screening may be sufficient for those who are not at increased risk of acquiring HIV infection.
• The U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to specify an HIV rescreening interval for non-high risk individuals, but recommends annual screening for high-risk groups such as MSM 2.

Comparison of HIV Testing Approaches

• A systematic review and meta-analysis compared the uptake of HIV testing in opt-in, opt-out, and risk-based testing approaches 3.
• The study found that opt-out testing was associated with a higher test uptake (64.3%) compared to opt-in testing (59.8%) and risk-based testing (54.4%) 3.
• However, the study did not provide specific guidance on the frequency of HIV testing for non-high risk individuals, but rather focused on the effectiveness of different testing approaches in increasing test uptake 3.