Let's Talk (Intelligently) About Sex

How are we still here?

Recently the NY Times reported on a poll that showed that fewer than half of all gay and bisexually identified men had been offered an HIV test by their doctors. This is despite the fact that the CDC has recommended universal HIV testing — HIV testing for EVERYONE — for over 10 years. This is despite the fact that men who have sex with men have disproportionate risk of acquiring HIV. This is despite the fact that research has clearly shown that people who don’t know they have the virus are at highest risk for passing it on.

The article makes me want to ask, “how are we still here?”, but I know the answer. Doctors are bad at talking to their patients about sex. We’re still using opt in instead of opt out models for HIV testing, and the virus is still stigmatized enough that uptake of voluntary testing is low. Most importantly, despite the existence of universal testing recommendations, we haven’t made HIV screening a regular part of medical practice.

There’s no excuse for it. With early testing and treatment, HIV can be a chronic disease. Furthermore, early treatment reduces the risk of further virus transmission. However, early treatment can’t happen without regular testing, and apparently regular testing isn’t going to happen without a significant sea change. Something has to happen to motivate doctors to realize that everyone is at risk for HIV and that screening is an easy way for them to impact that risk in their patient populations. They just have to start using it.

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