City Tests New Approach to HIV Screening

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Newly infected people with HIV are much more contagious than people who’ve had the disease for a while. That's because, in the first months after infection, they don’t yet have antibodies fighting and reducing the virus.

The city estimates there are almost 5,000 new HIV infections each year, but detecting them early on is a challenge because almost all tests are based on finding antibodies. If the body hasn't produced them yet, you test negative.

It's long been possible to test directly for the virus itself, but it's expensive and impractical for mass screening. A new city Health Department pilot program used an approach called “pooled nucleic acid testing” to detect the virus, and the results were published Thursday in the CDC's weekly public health update. The program screened 21,000 people and located 17 individuals with new, acute infections. Dr. Sue Blank of the New York City Department of Health and Mental Hygiene says that number might sound small, but it’s an important group.

"Seventeen acute cases of HIV has tremendous public health significance in terms of the impact we can have for preventing further spread from those seventeen to their sex- and needle-sharing partners," she says.

People with these early infections aren’t likely to know it, because when they get sick, the symptoms look a lot like flu – fever, sore throat, muscle aches. Dr. Blank says it’s better to prevent HIV transmission in the first place, but barring that, the findings of the pilot program suggest new, targeted screening efforts and greater awareness-building could improve detection of these very early, very contagious HIV infections.