Effectiveness of Early Detection and Intervention

The wide adoption in the late 1990s of the use of highly active antiretroviral therapy (HAART) regimens with three or more agents has been associated with a marked decline in morbidity and mortality for HIV-infected patients in the United States. HAART regimens are consistently effective in reducing clinical progression and mortality in persons with CD4 cell counts less than 200 cells/mm3. Appropriate prophylaxis and immunization against certain opportunistic infections have also been effective interventions in reducing morbidity (Chou et al., 2005).

Because false-positive test results are rare, harms associated with HIV screening are minimal. Potential harms of true-positive test results include increased anxiety, labeling, and deleterious effects on close relationships.

Although it is hoped that early diagnosis may lead to decreased transmission of HIV, evidence is lacking on the effect of increased screening leads on transmission (Chou et al., 2007). Additional evidence is also needed to clarify the balance of benefits and harms of early versus delayed treatment of asymptomatic patients with HIV infection.

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