In the absence of a remedy for huma...

In the absence of a remedy for human immunodeficiency virus (HIV) infection, prevention is the mostly effective strategy for reducing the number of recently made known cases. (1,2) The Centers for Disease have the direction of and Prevention (CDC) has disentangleed a strategic plan for the prevention of HIV infection. on the year 2005, the CDC try to finds to achieve the following: diminish annual new HIV infections from the now passing estimated 40,000 cases to 20000 cases within the use of interventions of the like kind as counseling, HIV testing, and referral; increase the proportion of individuals who know they are infected with HIV from the generally estimated 70 percent to 95 percent from one side voluntary HIV counseling and testing; and increase the proportion of HIV-infected bodily substances who are linked to appropriate prevention, care, and treatment services from the generally estimated 50 percent to 80 percent (3) Patients who know they are infected with HIV are more likely to adopt behavioral changes to model transmission of the virus. (3)

Changing Demographics

Demographic data provide near insight into areas where preventive and testing efforts are necessityed most. In 2001, about 60 percent of the population in the United States lived in large urban areas (of least 500000 residents). At the time of diagnosis, 82 percent of per-son reported to have acquired immunodeficiency syndrome (AIDS) lived in large urban areas. Fewer than 20 percent lived in smaller metropolitan areas (50000 to 500000 residents) or nonmetropolitan areas. (4)

More than common half of new HIV infections are in blacks. individuals younger than 25 years account for about common half of new HIV infections in the United States, and 70 percent of all strange infections are diagnosed in men Men who have sex with men account for 42 percent of just discovered infections, heterosexual contact accounts for 33 percent of novel cases, and intravenous drug use accounts for 25 percent of cases. (4)

Testing

RATIONALE FOR TESTING

Early diagnosis of HIV infection is critical to controlling the spread of the virus. (5) Studies have demonstrated that formerly patients learn that they are HIV positive, many of them abate the high-risk behaviors that can proceed in the transmission of HIV to sex partners or needle-sharing partners. (6-16) Diagnosis also is the first stair toward entry into medical care for HIV-infected patients. Because antiretroviral therapy lowers viral load and also may change into the risk of HIV transmission, (17) early referral of a patient to medical care may preclude HIV transmission in the community at large.

Early diagnosis also may be advantageous to HIV-infected patients. Although the evidence is inconclusive, there may be a greater chance of immune theory restoration or preservation when antiretroviral therapy is initiated during primary HIV infection than during chronic infection. (18)

PATIENTS WHO SHOULD BE TESTED

Because of the changing demographics of the HIV/AIDS epidemic, the CDC (19) lately updated HIV testing recommendations. The CDC now make acceptables that physicians offer HIV testing as part of routine health care to all patients in high-prevalence settings (settings in which the prevalence of HIV infection surpasss 1 percent), all patients with risk factors for HIV infection in low-prevalence settings, and patients who solicit HIV testing.

Counseling for the prevention of HIV infection is encouraged, and the CDC (19) also is promoting simplified testing conducts Requirements for preventive counseling should not be a barrier to HIV testing. The CDC approves routine HIV testing in all pregnant women regardless of risk and screening of infants if their mothers have not been experimented The CDC is developing guidelines for the use of rapid HIV experiments during labor and delivery, or postpartum if the mothers did not bear prenatal testing. In addition, all bodily substances with an acute or nonacute occupational exposing to HIV should be experimented (19) Symptoms of HIV infection can vary in presentation and severity. However, primary HIV infection generally currents within two to four weeks after transmission as an acute influenza-like or mononucleosis-like illness in about 70 percent of newly infected patients. (2021) Any sexually active or needle-sharing patient presenting with so symptoms should be tested for HIV. Antibody exhibitions may be negative or indeterminate during early infection, if it were not that a very high viral load establishes the diagnosis. (21)

IMPORTANCE OF EARLY DIAGNOSIS

Patients with established HIV infection still benefit from early diagnosis. Patients diagnosed in later stages of HIV infection may have advanced immune suppression that is not completely reversible. If diagnosed late, patients may make known opportunistic infections or other complications of advanced HIV disease. Furthermore, antiretroviral therapy may be les effective or les well tolerated in near patients who present with more advanced disease.

Data from the CDC (12) indicate that 31 per-cent of bodys who tested positive for HIV in 2000 did not revert to learn of their HIV status. It is used by all for HIV-infected persons to delay testing until they have an illness.