Implications of universal screening for HIV infection

Universal voluntary screening of all adolescents and adults for HIV infection is now recommended by the United States Preventive Services Task Force.1 This follows similar recommendations announced by the US Centers for Disease Control in 2006.2 Although there are good reasons for endorsing universal screening, the ethical and practical implications of this approach need to be considered.

Universal voluntary screening could help identify asymptomatic people who are infected with HIV but who might otherwise go undetected until late in the course of infection. It is essential to identify such people for their own personal health and the health of others to whom they may unwittingly transmit the virus. Because of advances in the care of HIV infection, early treatment is paramount, both for individual benefit and for decreasing the likelihood of transmission. Taken together, there is a clear public health imperative to screen for this infection.3

A crucial aspect of the task …