Statement of Anthony S. Fauci, M.D. Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health on National HIV Testing Day, June 27, 2009
The importance of National HIV Testing Day becomes clear when one recognizes that an estimated one-fifth of all Americans infected with HIV do not know they are infected. Among Americans who have been tested for the virus, more than one-third of those who learned they are infected became aware of their status less than a year before being diagnosed with AIDS — long after the optimal time to begin antiretroviral therapy.
Not knowing one’s HIV status endangers one’s health and the health of one’s sexual partners. By getting tested for the virus and learning one’s HIV status soon after infection, treatment can begin early, substantially delaying the development of HIV-related illness and prolonging life.
The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, urges everyone ages 13 to 64 to get tested for HIV as part of their routine health care, as the Centers for Disease Control and Prevention recommends. People at high risk for HIV infection — such as injection drug users, gay and bisexual men, female partners of bisexual men, and people with multiple sexual partners — should get tested at least once a year.
Widespread, voluntary HIV testing and treatment for infected individuals could benefit both people with HIV and their communities. Studies have shown that most people who learn they are infected with HIV adjust their behavior to avoid transmitting the virus to others. In addition, when HIV-infected people start antiretroviral therapy and take it consistently, the treatment reduces the amount of virus in their blood and other bodily fluids to very low levels. Not only does this protect their health, but it may also make them less infectious to others; a NIAID clinical trials network is in the process of testing this hypothesis.
This community-level benefit of HIV testing and treatment could assume greater importance in the future as scientists examine a compelling new model for HIV prevention. This mathematical model, developed by scientists at the World Health Organization, predicts that within 10 years of implementation, a program of universal, voluntary, annual HIV testing and immediate treatment for those who test positive could reduce new cases of HIV by as much as 95 percent.The model further predicts that this strategy, called test and treat, could end the HIV pandemic within 50 years. However, the test and treat model contains many assumptions that need to be validated and raises issues that require broad public debate. NIAID has begun conducting research to validate some of these assumptions and address some of these issues.
Meanwhile, CDC has launched an important initiative, Act Against AIDS, designed to dramatically increase the number of Americans who get tested for HIV and who take action to protect their health and the health of their sexual partners. To learn more, go to http://www.cdc.gov/nineandahalfminutes/.
On this year’s National HIV Testing Day, let us remove any stigma and fear that surround HIV testing and recognize its lifesaving value. By doing so, we are taking a critical step in containing the terrible scourge of HIV, protecting our own health as well as the health of our communities. To find an HIV testing site near you, go to www.hivtest.org. For more information about HIV testing, go to http://www.aids.gov/testing/index.html.
Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.
1 CDC. 2008. HIV prevalence estimates — United States, 2006. MMWR 57(39):1073–1076. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a2.htm.
2 CDC. 2009. HIV/AIDS Surveillance Report, 2007. Vol. 19. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, p. 13. Available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2007report/default.htm.
3 For example,
-- Colfax, GN et al. 2002. Sexual risk behaviors and implications for secondary HIV transmission during and after HIV seroconversion. AIDS 16(11):1529–1535.
-- Weinhardt, LS et al. 1999. Effects of HIV counseling and testing on sexual risk behavior: A meta-analytic review of published research, 1985-1997. American Journal of Public Health 89(9):1397–1405.
4 Granich RM et al. 2009. Universal voluntary HIV testing with immediate antiretroviral therapy as a strategy for elimination of HIV transmission: a mathematical model. Lancet 373(9657):48–57.