Monday, August 4, 2008

HIV Screening for All Women

.....regardless of age!

The August issue of Obstetrics & Gynecology published a committee opinion suggesting "Routine Human Immunodeficiency Virus Screening" for all women between the ages of 19 and 64.

The article estimates that one-quarter of all Americans with HIV are unaware of their status. Women continue to represent a growing proportion of HIV and AIDS cases, and it's critical that they know their status.

When we add the HIV numbers to the fact that one out of every four women over the age of 12 would test positive for incurable genital herpes (according to the CDC one third of these women are asymptomatic and don't know they are potentially infecting everyone with whom they have a sexual encounter). Lest you male readers think you are off the hook, one out of every five of you would test positive for genital herpes -one third of all males with genital herpes are asymptomatic, as well.

Given this data, isn't it time for all health professionals to stop acting like teenage and senior sex doesn't happen. This includes eye care professionals, since both ocular herpes and AIDS are potentially blinding diseases.

Hopefully, cross- talk between all medical specialties will soon become the norm.


Rachael Sudul said...

I completely agree. The statistics are staggering in this country yet the majority of our focus on AIDS/HIV has been on the people of Africa, India, etc. AIDS is the number one cause of death for young African American women in the USA!!!
We should be screening everyone for HIV at all annual physicals, and all prison physicals... we need to move beyond the stigma of the disease and have a reality check. HIV needs to become a normal thing to talk about and a normal thing to test for. If there's a breakout of Tuberculosis, we deal with it and take care of it without any moral judgment. How did unfounded moral judgment get in the way of treating patients?
When I was pregnant with both children it was mandatory that I was tested for HIV because it could effect each child. Couldn't you use the same logic to require testing for everyone? Unless you live alone on a deserted island, your HIV status would be important to everyone around you. The ACLU claims this opens people up to discrimination and unfortunately they have reason for concern. However it seems to me there could be a way to keep status confidential. That would require personal responsibility on the part of citizens to become aware of their own limitations and take particular precautions with future partners if they are infected, but it's a place to start.
I hope the medical professionals can campaign to make HIV a more common topic, normalizing the subject and the testing. It's in everyone's best interest.

Ellen Troyer, MT MA said...

Beautifully said Rachael!

Until all medical specialties take the time to address the reality of sexually transmitted diseases, we won't be able to eliminate them.

Desiring sexual activity is natural; it's how human beings were designed and the desire starts with puberty; not with marriage.

We were ALL shocked when the CDC reported that incurable genital herpes existed in 25% of the female population over the age of 12. That's a year past the age when most girls enter puberty, so it should not be that shocking to anyone except those who still think that puberty starts at age 15 or so.
If we are to successfully address the epidemic of sexually transmitted disease, we much deal with reality.

Joe Kirkland said...

I am amazed at these numbers, expecially the large number that are unware.

On Tuesday, the California-based think tank Black AIDs institute released a report that suggests that the AIDs epidemic among Africian-Americans in parts of the US is as severe as it is in parts of Africa.

How can we not have some type of routine virus screening??????

Sue Ann said...

Before I got married I got tested for HIV and other sexual transmitted diseases. It cost me a fortune. I cried when I saw the bill. I think if someone is sexually active they should be tested at their yearly checkup and insurance should cover it.

Margaret Morse, RN said...

It hard to believe so many 12 year old children are having sex.

Instead of the "just say no" approach, maybe it's time that more parents start realistically talking to their children about physical desire vs. emotional readiness?

Jeffrey Anshel said...

The way our society works (assuming that it does)is to take a "disaster" (which could be an infectious disease) and heighten awareness to resolve it. However, as time goes on, we get lax again and it takes another disaster to bring it back to our attention.

Let's just hope that it doesn't take a "plague" to get us concerned again....

Ellen Troyer, MT MA said...

Sue Ann, you right on the money!!!!

Insurance pays for testing for other communicable diseases, why not sexually transmitted diseases?

Better yet, why don't we put more focus on believable STD prevention?

It doesn't require an advanced Harvard degree to figure out that preventing STDs, or treating them very early costs less than treating them, and the whole host of associated medical problems they cause, later.

Alex C said...

Ellen, thanks for touching on such an important subject. HIV/AIDS is not an age discriminating, gender based or race determined disease. It should not matter how old/young you are, if you are male/female, or black/white/red/yellow. The fact is if you are sexually active you need to be responsible to request and receive and HIV/AIDS test, at a minimum, yearly. It is also the responsibility of parents/guardians to have HIV/AIDS conversations and education with those younger family members who are sexually active (Mom and Dad don't think in today's society that your children/neice's/nephew's are not having sex, as they are)(Look at is based on sex!). As for the medical world I belive a HIV/AIDS test should be included as a yearly checkup/physical. Insurance companys should cover testing expenses along with medications and counsiling for those that test "positive". 10 years ago we were talking openly about battling HIV/AIDS and we were gaining ground. Now we seem to have closed lips on this topic and think a "cocktail of medications" will solve this problem. WAKE UP is time to communication and re-educate eachother.

Anonymous said...

I hope you Biosyntrx people are not condoning or recommending sex before marriage, especially for children as young as 12.

Ellen Troyer, MT MA said...


Of course we are not recommending that children become sexually active. But, some of them are and we can no longer act like it does not happen, particularly when it is leading to uncureable diseases.

In the best of all worlds, teenagers would be taught that sexual activity should wait until emotional maturity catches up with physical maturity. However, in the "I want what I want and I want it now" modern world, that's now what's happening in junior high and high schools all over the country.

So, we can either bury our heads in the sand, or we can address the issue with appropriate concern and intellectual compassion.

Mable said...

Hey Ellen,

What the hell kind of world are we living in?

How many of your readers are aware that Viagra is covered by insurance and AIDS testing is not, nor are birth control pills or condoms?

Anonymous said...

In response to Mable's comment, birth control pills are now covered by most insurance companies. However, it is an absolute shame that Viagra is covered by insurance companies and AIDS testing and the HPV prevention treatments are not! We really need to get our priorities in order!

jp said...

This goes out to anonymous:

It's easy to see that teen pregnancy has gone up over the years...meaning (whether we like it or not) sex IS happening! We need to take the responsibility and educate our children how to be safe if and when the time comes.

I'm an avid reader of this blog and I'd say that Biosyntrx is not recommending sex before marriage but recommending PREVENTION!

Marsha Bartenetti said...


I love that this is being discussed! So needed - and indeed, the CDC just came out with the report that 1 in 4 teenage girls has an STD! If that is not an absolute "in your face" statistic that will wake people up I dont know what will. Our girls are in trouble - BIG TIME> I am heartsick about it.

AND 1 in 20 of Washington DC's population - including men, women and children - has HIV/AIDS !!
We need to help change the paradigm of behavior by stopping to make sex a subject we refuse to acknowledge with our young girls!..
AND our newly divorced or widowed women who are out there again. - who are fast becomeing a huge population of people infected with STD's and HIV/AIDS - who actually still believe condom use is only to prevent pregnancy -
It really is shocking to hear what is going on out there..
But even more shocking that we pretend that if we teach abstinence only in the sex ed classes that we can go to sleep knowing that we havent promoted sex to kids who are already inundated with sexual images in all types of media -
Guess what - it isnt realisitc and it isnt working.
We have to have more faith in our children - and our ability to affect their behavior - by actually talking with them - and makinng sure they protect themselves.

My daughter and I started a company called
Just In Case, INc. We design and manufacture the first chic, and discreet intimacy compact that has a mirror and a hidden compartment that holds condoms - called JUST IN CASE -
It is the perfect conversation starter for mothers and daughters who are at the age where they might think of being sexual - or going off to college - (I wish I had had JIC back then!)

Or a gift for yourself or anyone who is sexually active....single...

Its time to bring into a conversation about sex - that safe sex is a NON NEGOTIABLE point in the relationship. And its up to the women to do so.

Women have historically been the compass in any relationship and they need to remember their value again - Men have also historically wanted to please their women - and it is time that they do again - by honoring their requirement for safe sex practice - a conversation from father to son.
It will make them better men.

We would also like to offer your readers a discount on our compacts by going to our site:
and enter LOVEWELL
For a discount on your purchase..

Lets stop the madness - and lets get beyond the statistics to be agents for positive change in behavior in the area of sexual health.

P.S. If you buy a YouthAIDS red compact a portion of the sale will go directly to
We are honored to be partnering with them this year.
Marsha Bartenetti
Just in CAse, Inc.

Ellen Troyer, MT MA said...

Thanks Marsha,

Biosyntrx is committed to patient and physician cross-talk education about disease prevention: including nutrition and lifestyle choices that dramatically affect personal and government healthcare spending.

The potential medical consequences of unprotected sex certainly falls into that category. Therefore, we will make every effort to encourage eye docs to discuss this issue with appropriate patients because preventing STDs could save eye sight for people of all ages.

Thanks again for your generous offer to the Biosyntrx Blog readers and good luck with your company and your committment to raising funds for YouthAids.

Jeffrey Anshel said...

From: Estimation of HIV Incidence in the United States
JAMA, 2008; 300(5): 520-529

An estimated 39,400 persons were diagnosed with HIV in 2006 in the 22 states. Of 6864 diagnostic specimens tested using the BED assay, 2133 (31%) were classified as recent infections. Based on extrapolations from these data, the estimated number of new infections for the United States in 2006 was 56,300 (95% confidence interval [CI], 48,200-64,500); the estimated incidence rate was 22.8 per 100 000 population (95% CI, 19.5-26.1). Forty-five percent of infections were among black individuals and 53% among men who have sex with men. The back-calculation (n = 1.230 million HIV/AIDS cases reported by the end of 2006) yielded an estimate of 55 400 (95% CI, 50,000-60,800) new infections per year for 2003-2006 and indicated that HIV incidence increased in the mid-1990s, then slightly declined after 1999 and has been stable thereafter.

Conclusions This study provides the first direct estimates of HIV incidence in the United States using laboratory technologies previously implemented only in clinic-based settings. New HIV infections in the United States remain concentrated among men who have sex with men and among black individuals.

Ellen Troyer, MT MA said...

Don't let studies like this lure you into believing that unprotected sex is safe if you don't have sex with gay men, or if you are not black.

I question any science that suggests 98% of the new AIDS cases are confined to these two populations, since sexual promiscuity is hardly confined to blacks and gay men.

Would you consider the possibility that the JAMA study stats could have been gathered from inner-city public health departments, not from private physicians who treat the majority of straight, white males and women with AIDS and other STDs?

We are scientists and we know that lots of studies with unreliable data get published, particularly if the author overlooks data that does not agree with his or her hypotheses.

When I read this type of study I always try to find out who funded the research and who benefits most from the results?

PharmacistMike said...

Regardless of insurance coverage people can always buy the single FDA-approved home HIV test for their children or spouse to use. This may help increase the numbers being screened.

Ellen Troyer, MT MA said...


Thanks for this important information. I'm sure many people are not aware of the home AIDS test that looks for the presence of HIV antibodies. The Home Access Express HIV-1 Test System is the only one approved by the FDA.

Many states fund centers that are set up to test for a group of STDs in one visit: Chlamydia, Bacterial Vaginosis, Genital Warts, Gonorrhea, Hepatitis B and C, Herpes, Syphillis and HIV.

However, if we don't discuss the importance of being tested, most folks don't do it - even well-educated adults who are sexually active and should know better.

Get informed and get tested!

Barbara Morse, RN said...

It's comforting to think that primary eyecare docs are discussing diet, nutrition and lifestyle issues that affect vision and overall body health. All too often they may be the only healthcare professional a patient sees for a number of years.

Curious said...

Does anyone know how many cases of ocular herpes have occured in herpes infected dry eye patients dropping Restasis?

I understand that Allergan has now changed "T-cell inhibiting to T-cell modulating" in their professional education material.

Is this true?