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View Full Version : British Columbia public health wants every adult having sex tested for HIV



Teh One Who Knocks
11-09-2011, 10:16 PM
By Pamela Fayerman, Postmedia News


http://i.imgur.com/ZR3qf.jpg

VANCOUVER — Adults living in Vancouver or Prince George, B.C., who have had sex likely will be asked to take an HIV detection test at the next lab, hospital or medical clinic they visit under Canada's first such pilot project.

They can refuse the offer but won't be able to avoid the HIV testing guerrilla marketing campaign delivered via social media, bus shelters and websites. The "seek and treat" program is meant to identify up to 3,500 more cases of HIV in B.C.

That's the number of adults estimated to be infected who don't know it, since symptoms of HIV can be silent for as many as 10 years, according to public health authorities.

Under a four-year, $48-million program funded by the provincial government, family doctors are being urged to add HIV testing for all their adult patients being sent for other types of blood tests.

Many patients recently admitted and/or treated at St. Paul's, Mount St. Joseph and Vancouver General Hospital have been offered the tests as well. University of British Columbia Hospital patients will be included next year.

Intensive-care, palliative and psychiatric patients will not be included in the screening program.

Lab tests cost up to about $300. The initial test, if it is negative, costs between $10 and $25. If the initial screening test is positive, more tests are done to confirm the diagnosis.

Lab tests conducted as part of routine blood work are cheaper, which is why doctors are being urged to add the HIV screening tests when ordering other tests.

The program is purposely casting a wide net as it seeks those who are outside the usual HIV risk group scope, said Dr. Reka Gustafson, medical health officer, communicable disease control, for Vancouver Coastal Health.

"No question about it, this is a big practice change. In the past, we have targeted people in high-risk groups (like men who have sex with men) but now we need to go beyond that and offer tests to anyone who has ever had sex. It will not only reduce the stigma of such testing but it will also improve our early detection rates," she said.

Even before the program ramp-up this week, hospitals and doctors were ordering more HIV tests, resulting in more cases being detected. In the months of June, July and August last year, 45 cases of HIV were detected in Vancouver but in the same months this year, there were 78.

About 200,000 HIV tests are conducted annually in B.C. and such blood tests have detected nearly 14,000 cases of individuals now living with HIV. Last year, there were 301 new HIV cases in B.C; three of every 1,000 tests results in an HIV diagnosis.

British research has demonstrated a cost benefit when the prevalence of diagnosis is one or two out of every 1,000 tests.

"We expect our diagnostic yield be higher than that," Gustafson said.

Detecting and treating HIV, especially in its early stage, helps reduce medical costs and prevents further transmission. Highly active anti-retroviral therapy (HAART) suppresses the virus to undetectable levels. B.C. research has shown that 40 per cent of those who died of HIV-related causes between 1997 and 2005 had never received the life-saving medication. Citing U.S. Center for Disease Control research, Gustafson said lifetime HIV treatment costs nearly $400,000 per patient, but patients diagnosed early enough require less treatment, saving the health-care system up to $61,000 per patient.

About 14 per cent of people newly diagnosed have advanced disease at the time of diagnosis, which suggests they ignored symptoms or had no symptoms before they were tested.

The screening program will be evaluated for effectiveness, including cost benefits, and if it is deemed to be successful, it is expected it will become part of routine health care.

Hal-9000
11-09-2011, 10:20 PM
I think it's a good idea.We have a disease that's transmitted a number of different ways and offering to do a mass blood test will save lives.


I've taken the test in the past and had a doctor who was an uneducated asshole try and embarrass me about it.I left a written complaint at the clinic.

JoeyB
11-09-2011, 11:13 PM
I think it's a good idea.We have a disease that's transmitted a number of different ways and offering to do a mass blood test will save lives.


I've taken the test in the past and had a doctor who was an uneducated asshole try and embarrass me about it.I left a written complaint at the clinic.

What did he do?

Deepsepia
11-10-2011, 01:21 AM
Not such a great idea to do screening of unlikely populations-- you get a very high false positive/true positive rate in low risk populations, which causes a lot of anxiety and wastes medical resources (eg what do you think happens when you tell 35 year old mom that she's HIV+? She freaks out, she accuses her hubby of fucking around on the down low . . . and it just gets worse from there).

I think it was Indiana which, years ago, required an HIV test for a marriage license. Well, folks in Indiana who are getting married are a super-low risk population, and so when folks tested positive, it was almost always a false positive.



The cost and risks of screening should not outweigh the benefits. Cost includes the financial burden of the screening program and follow-up and the potential personal cost to the people being screened in money, time, and effort. Is there excessive anxiety or inconvenience associated with the screening test or the follow-up needed for positive test results? How does this balance against the possible benefit for each patient? When Indiana instituted mandatory screening for the human immunodeficiency virus (HIV) as a requirement for a marriage license, false-positive results greatly outnumbered true-positive results. Within one year of beginning the program, a substantial proportion of Indiana residents were driving across state lines for their marriage licenses to avoid the expense of the HIV test. People were inconvenienced, and the state lost substantial revenues—all with little benefit.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070874/

Godfather
11-10-2011, 04:16 AM
:hand: The lady doth protest too much, methinks

deebakes
11-10-2011, 04:29 AM
bc'ers are dirty :nono: