Routine Screening for Chronic Human Immunodeficiency Virus Infection: Why Don't the Guidelines Agree?

Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Code: BICC, Portland, OR 97239, USA.
Epidemiologic Reviews (Impact Factor: 6.67). 05/2011; 33(1):7-19. DOI: 10.1093/epirev/mxr001
Source: PubMed


Infection with human immunodeficiency virus remains a major public health problem in the United States. Prominent guidelines
from the U.S. Preventive Services Task Force and the Centers for Disease Control and Prevention differ in their recommendations
on whether and how to screen adults and adolescents not known to be at higher risk. These discrepancies have led to controversy
and debate as well as confusion among clinicians. This article reviews principles of screening, explains specific issues related
to screening for human immunodeficiency virus, reviews the discrepancies between the US Preventive Services Task Force and
the Centers for Disease Control and Prevention guidelines and the methods used in each guideline, and describes potential
reasons for the discrepancies. The case of screening for human immunodeficiency virus illustrates how discrepancies between
guidelines may be related to different guideline development methods as well as the different perspectives of the guideline
development groups.

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