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With the CDC urging screening for all willing patients, providers will be testing and managing a growing number of HIV-positive individuals.

The CDC estimates that with more than 40,000 new infections annually, more than 1.2 million people in the United States are living with HIV-and 24% to 27% may not be aware of their infection status.1 Studies have shown that HIV is often diagnosed late in the disease process, when the individual has already developed AIDS, which typically occurs 8 to 11 years after HIV infection.2 Research also points to missed opportunities to offer HIV testing and diagnose the infection before AIDS develops, which would enable the newly diagnosed individuals to employ precautions to protect their partners from becoming infected.3,4 Almost half of HIV transmissions studied by Brenner et al were attributed to transmission by newly infected persons.

In response to these issues, the CDC put forth revised recommendations for HIV testing that encourage screening for patients in all healthcare settings after the person is notified that testing will be performed, unless he or she declines (opt-out screening).4 Primary-care providers need a better understanding of trends in HIV infection and what to do when an HIV test is positive. In a recent survey of 1,165 primarycare providers, 54% of the respondents reported treating HIV-positive individuals, with 43% indicating an "increased" or a "dramatically increased" caseload over the past year.



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