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Tuesday, November 20, 2012

Americans urged to get one HIV test - analysis

Reproduced here for fair use and discussion purposes. My commentary interspersed in bold.
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This little bit of news reads like a press release. The U.S. Preventive Services Task Force is a government agency with an advisory board made of of healthcare professionals. Their website has this logo and motto: 
WASHINGTON: There’s a new push to make testing for the AIDS virus as common as cholesterol checks (well, no. Cholesterol checks are done more than once in a lifetime, while this HIV proposal is once for everyone.).

Americans ages 15 to 64 should get an HIV test at least once — not just people considered at high risk for the virus, an independent panel (of a government agency) that sets screening guidelines proposed Monday.

The draft guidelines from the U.S. Preventive Services Task Force (This is the same group that famously recommended that "...women in their 40s should not routinely have mammograms and that women between ages 50 and 74 should have mammograms every two years instead of annually.") are the latest recommendations that aim to make HIV screening simply a routine part of a checkup, something a doctor can order with as little fuss (Because we don't want people fussing about being tested for something they have little risk of contracting) as a cholesterol test or a mammogram. Since 2006, the Centers for Disease Control and Prevention also has pushed for widespread, routine HIVscreening. 

Yet not nearly enough people have heeded that call: Of the more than 1.1 million Americans living with HIV, nearly 1 in 5 — almost 240,000 people — don’t know it. Not only is their own health at risk without treatment, they could unwittingly be spreading the virus to others. (There is only one reason that this recommendation is being made. It is to continue the thrust into the public consciousness of certain preferred issues and make them a part of our thinking. Consider that the Task Force is proposing testing based on a premise, that is, a number of people are unaware of their condition and are spreading HIV. Let's run the numbers. 1.1 million infected people constitutes .035% of the population (I bet that you thought it was much higher given the amount of hysteria surrounding funding, etc). Of those, 240,000 people are unaware of their condition, an infinitesimally small percentage of the population. 

For this number, the Task Force deems it necessary that EVERYONE get tested. By contrast, according to the CDC, every year 210,000 women get diagnosed with breast cancer, 935,000 are diagnosed with heart disease, and 215,000 men are diagnosed with prostate cancer. 

There is no real possibility of bringing the risk of contracting these conditions to zero. But with HIV, you can. Remain celibate until marriage, marry someone who is the same, and remain faithful after, and you will never catch HIV.

But the real irony of the whole situation is that there is no contingency to the testing, so testing will not reduce the incidence of HIV. No one is asked to change their behavior or cease engaging in risky activities. Well, except condoms, but that is the, shall we say, prophylactic argument used to insulate advocates from their critics. 

In other words, the only thing gained by universal HIV testing is a person will know they are infected, but precious little else. The disease will not be stopped, it will not even be reduced. But the cause de jour will receive all sorts of press coverage, complete with sob stories and mentions of how eeeevil conservatives are for not caring and for not increasing HIV research funding.)

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