The US Centers for Disease Control is considering the value of offering HIV tests at US pharmacies, to accelerate identification and treatment of Americans who don't know they are infected with the virus.
Some 1.1 million people in the US carry HIV, but an estimated 200,000 of them are unaware. The earlier these carriers are identified, the sooner they can begin receiving treatment that prevents their condition from progressing to AIDS ? and the fewer people they will infect unintentionally. At the moment, one-third of those with HIV are diagnosed so late that they develop AIDS within a year.
"People knowing their HIV status is empowering," says Paul Weidle of the CDC in Atlanta, Georgia, head of the two-year pilot project to offer testing in 12 rural and 12 urban regions with abnormally high burdens of HIV. "If they're negative, that's reassuring in itself, and if they're positive the treatments available are very effective, and they can take steps to avoid infecting others," he says.
The CDC first introduced routine testing in 2006, but mainly in the context of hospital and family doctor visits. Making the tests available in pharmacies and retail clinics would massively broaden availability because millions of people visit them weekly, and 30 per cent live within a 10-minute drive of a retail clinic.
Another goal of making testing more available is to limit the stigma of being HIV-positive. "Our goal is to make HIV testing as routine as a blood pressure check," says Weidle.
Once the pilot finishes, Weidle and his colleagues aim to develop HIV testing "toolkits" that could rapidly be made available to any pharmacies or retail clinics on request.
In May, the US Food and Drug Administration opened a new front against the disease by recommending that antiviral drugs be offered to people who don't carry HIV but are at risk of infection, perhaps due to their lifestyle or because their partners are infected.
The move is symptomatic of a global shift towards prevention. As part of that, the WHO is also keen for tests to be offered more widely elsewhere in the world.
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