Today is National HIV Testing Day (NHTD) across the United States. We are proud to partner with GreaterThanAIDS and Walgreens to help get free tests to anyone who needs one. Each year on June 27th, the day is observed to help emphasize and encourage testing. This year, the theme is ‘HIV Testing is Self-care.’ The WHO defines self-care as “the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider.”
Why National HIV Testing Day is Important
As part of overall health, regular STI testing (including HIV) is vital and can help people make informed health decisions. HIV.gov shows that HIV infection rates have decreased 8% from 2015 to 2019, with the estimated number of new infections at 34,800 (or 12.6 per 100,000 people), but there is still much work to do. As we continue to work to decrease and eventually eliminate HIV infections, it is disheartening to see the number of new HIV diagnoses was highest among people aged 25 to 34, showcasing that more awareness and education are needed to ensure that young people are aware of how HIV is transmitted and what they can do to protect themselves.
The Importance of Testing
Testing plays an important role in addressing the HIV epidemic. In the US, nearly 1 in 8 (an estimated 13%) do not know their status, accounting for nearly 40% of new transmissions. Learning their status allows those living with HIV to connect to care and start treatment to reduce their viral load and prevent further spread. With highly effective treatment, it is possible to have undetectable viral loads. In recent years, scientific evidence has shown that with HIV, undetectable equals untransmittable (or, as the campaign states, U=U.) While it can take up to 6 months to achieve an undetectable viral load, this advance in medicine has proven an excellent tool in the fight to end HIV. It also showcases the importance of testing to ensure that people can learn their status, get treatment, and help reduce the spread of the virus.
US HIV Demographics
While women have been impacted and can contract HIV, it has predominantly impacted those who identify as men, who had 81% of new diagnoses in 2018.
- At the end of 2018, there were an estimated 1.2 million HIV infections in the US
- 912,100 of these were men
- In 2018, of the 37,968 new HIV diagnoses in the US, 81% were men
- In 2019, nearly 7,000 of the new cases were among women, though this number has been decreasing
- The main transmission category was through sexual contact, with injection use as the next most frequent
- Anal sex is the riskiest type of sex for getting or transmitting HIV
- Receptive sex is 13 times as risky for getting HIV as insertive anal sex
- Men can also get HIV from having vaginal sex with a woman who has HIV
- Women can get HIV through vaginal or anal sex
- Any gender can get HIV through the use of injecting drugs or unsafe sex
- In 2018, of the 3,864 HIV diagnoses attributed to injection drug use, nearly 73% (or 2,806) were among men
While there has been steady progress over the past four decades against HIV/AIDS, work is needed to increase access to equitable HIV testing and build awareness. According to the CDC’s Behavioral Risk Factor Surveillance System in 2019, only 43% of adults (18-64 years) in the US have reported ever testing for HIV. Of course, testing rates vary by demographics and locations, but this highlights the need to increase both awareness and access to help reduce the number of people who are unaware they are HIV-positive.
Testing Recommendations and Requirements
The CDC (Centers for Disease Control and Prevention) recommends everyone aged 13-64 receive at least one HIV test as part of regular healthcare. More frequent testing, at minimum, annually, is recommended for higher-risk demographics. The CDC recommends that the below groups may benefit from annual screening.
- Sexually active gay or bisexual men (some of whom may benefit from more frequent testing, such as every 3 to 6 months)
- Individuals who have had sex with an HIV-positive partner
- Individuals who have had more than one partner since their last HIV test
- Those who have shared needles or inject drugs
- People who have exchanged sex for drugs or money
- Individuals who have another sexually transmitted disease, hepatitis, or tuberculosis
- Those who have had sex with someone who has participated in any of the above activities or with someone with an unknown sexual history
The CDC also recommends that all HIV screening be voluntary and opt-out rather than opt-in. This means that the patient is notified that the test will be performed, and consent is inferred unless the patient declines instead of where the patient is offered a test and must explicitly consent to an HIV test, often in writing.
In certain cases, such as with blood and organ donors, military applicants, federal and state prisoners in certain circumstances, and newborns in some states, HIV testing is still mandatory. As of January 2010, HIV testing is no longer mandatory for those wishing to emigrate to the United States or refugees.
Prevention and Harm Reduction
Certain factors are known to reduce the risk of HIV transmission, including practicing safe sex (using condoms and having open conversations about sexual history with partners), using PrEP and PeP, and antiretroviral treatment (ART) for those who are HIV positive. Check out our previous blog on the ‘Ins and Outs of HIV Transmission’ to read about transmission and prevention in more detail.)
Today is a great initiative to help build awareness and create better access to equitable testing across the country so that everyone that needs a test has one. With HIV, the only way to know is to get tested. It’s the first step to staying healthy. Check out the links below to find a free test and learn your status today!