- Universal, routine, opt-out screening should be provided to adolescents and adults, as recommended by the Centers for Disease Control and Prevention (CDC), and by the U.S. Preventive Services Task Force (USPSTF). Screening methods and confirmation algorithms used should be selected from the latest recommended by CDC or by the National Institutes of Health (NIH).
- Risk assessment and effective prevention messages should be offered to all persons testing negative who can be accessed for such services, with availability of counseling, referrals, and repeat screening based on risk. Nucleic acid or antigen screening at the initial visit should be considered for those with very recent suspected exposure (such as partners of persons with detectable viral loads or persons who have very recently engaged in high risk sex), if these may detect early infections that have not yet produced antibodies.
- Prompt and routine initial outreach services, consistently and adequately funded in all local jurisdictions nationwide, should be provided for all individuals confirmed as testing positive:
- Maintenance of continuous HIV care, including integrated prevention measures, should be optimized by competent providers and support resources, including the following services:
- Prophylactic use of antiretroviral medications
by uninfected persons should gradually
become less necessary with implementation of the above strategy.
and should be for clear and limitedIts indications should be approvedprioritized by CDC. Pre-exposure prophylaxis should not be advocated as a substitute for condoms. The efficacy of intra-exposure prophylaxis with various regimens for sero-negative partners of persons known to be infected and on treatment, e.g., if viral load is still detectable on treatment, or when condoms are refused or deferred to attempt pregnancy, should be intensively studied.