II. History

III. Epidemiology

  1. Increasing risk in age under 20 years and rural communities

IV. Indications: Screening (USPTF, 2013)

  1. Screen all patients ages 15 to 65 years (unless patient opts out, refuses)
    1. Screen up to annually depending on risk
    2. CDC recommends starting screening at age 13 years
  2. High risk indications (more frequent screening, at least annually, and regardless of age)
    1. See risk factors below
  3. Other indications
  4. New diagnosis of Tuberculosis at onset of treatment
  5. All patients presenting with possible Sexually Transmitted Disease related concerns
  6. All pregnant patients with Prenatal Labs (and again in third trimester in high risk patients and communities)

V. Risk Factors

  1. Sexual contact (primary mode of transmission)
    1. Men who have Sex with Men (most common risk)
    2. High risk heterosexual contact
  2. Intravenous Drug Abuse (injection Drug Abuse)
  3. Unprotected vaginal or anal intercourse
  4. High-risk sexual partners or behaviors
  5. Sex Workers
  6. History of Sexually Transmitted Disease

VI. Background: Medicolegal recommendations by CDC

  1. Routine HIV Screening falls under consent for general medical care and should not require additional consent
  2. Opt-out screening is typical policy where patient specifically declines HIV Screening
    1. In contrast, opt-in only screening misses 25% of HIV cases
    2. Walensky (2002) Arch Intern Med 162(8): 887-92 [PubMed]

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Ontology: HIV risk lifestyle (C0425042)

Concepts Finding (T033)
SnomedCT 266974005, 138292008, 160973006
English Human immunodeficiency virus (HIV) risk lifestyle, Human immunodeficiency virus (HIV) risk lifestyle (finding), Human immunodeficiency virus risk lifestyle, Human immunodeficiency virus risk lifestyle (finding), HIV risk lifestyle (finding), AIDS risk lifestyle, HIV risk lifestyle
Spanish estilo de vida de riesgo para el VIH, estilo de vida de riesgo para el virus de la inmunodeficiencia humana, estilo de vida de riesgo para el virus de la inmunodeficiencia humana (hallazgo)