Written Assignment, Unit 3

Written Assignment, Unit 3
Epidemiology
HS 3311-01 - AY2022-T5
Mehrnaz Siavoshi
(Instructor)
HIV Screening
Introduction and definitions
In Epidemiology or in public health for that matter, the reduction of morbidity or mortality
is of great importance and among the population is up to a great extent achieved through
screening. This preliminary examination is aimed at identifying “unrecognized disease or
defect” (Robert H. Friis. 2018) among the population “by the application of tests,
examinations or other procedures which can be applied rapidly.” (Robert H. Friis. 2018)
Nowadays, many types of tests are performed during a person’s lifetime that are examples of
screening tests, such as checking for the presence of abnormal defects in newborn babies,
tests for STD’s, diabetes, cancer, etc. There are manly voluntary and free screening tests
performed throughout pharmacies and drug stores, such as blood-pressure or cholesterol
levels and are done massively and easily found and available. Such tests aren’t the same as
diagnostic tests, but preliminary evidence, nonetheless a fast and less expensive tool to
identify early markers of disease. These are normally used to screen among the asymptomatic
population for the likelihood for disease with consequently positive cases referred to
diagnostic testing. (Aschengrau & Seage. 2020) Moreover information gathered from a
screening proceeding is considered alongside disease surveillance as it happens in
occupational health. Both complement each other since they help gather data about morbidity
and mortality in a population. These are helpful in monitoring high risk groups in the case of
STD’s patients or infectious diseases transmissible sexually or through blood. Moreover,
screening tests are usually divided into two categories, mass and selective screening. The
first one points to the application of testing on the total population regardless of the risk group,
such as those applied to newborn babies. The second type are usually applied to high-risk
groups such as those at risk for STD’s. This type, selective screening is mostly effective in
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detecting infectious diseases, chronic diseases and other conditions resulting among persons
with risk factors. (Robert H. Friis. 2018)
Discussion of HIV screening
When discussing the natural progression of the disease, screening enters not in prevention,
since it may only identify disease and not prevent it, but in early detection of the disease. The
disease onset is biological, and mostly doesn’t produce symptoms. This might be the first
mutation of a cell and its proliferation or the entering of a virus into a cell and its replication
onset. Screening is therefore used in asymptomatic people to identify for disease. This usually
adheres to certain conditions among specific groups in the population in which prevalence is
high and screening costs are low. If an asymptomatic person, through a screening test is
identified of having a certain disease, treatment may commence right away, minimizing
damage done and therefore extending health. This scenario is unfortunately not so common,
as most people only after developing symptoms will seek medical help. (Bovbjerg, M. 2020).
HIV is the virus associated with AIDS, and it continues to be a major global public issue. On
the contrary to what many people might guess, there’s no cure for HIV infection, however
with proper screening, diagnosis, treatment and care it has become a manageable chronic
condition that enables patients to lead long lives. At the end of 2020, more than 37 million
people worldwide were living with HIV, two/thirds of which is found in sub-Saharan Africa.
A great many people with HIV are unaware they are infected, and “undiagnosed HIV infected
individuals transmit about one/third of new HIV cases annually.” (Robert H. Friis. 2018)
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HIV screening is recommended by the CDC for all patients from 13 to 64 years old, and to
all pregnant women. Patients in greater risk of contracting HIV are recommended to be
screened annually.
For HIV as well as any other disease, a good screening test should hold these five
characteristics:
1) Be Inexpensive.
Routine screening is very cost effective, since its incorporated into a regular blood work.
2) Easy to administer.
There are HIV self-tests or kits, a person may choose from. Oral rapid self-tests that are done
at home where the results are produced in 20 minutes. Also available are self-tests through
the mail where a blood sample is collected and sent through. (CDC. 2022).
3) Produce minimal discomfort.
Both self-tests produce minimal discomfort.
4) Reliable (consistent).
Home tests are less sensitive, therefore less reliable than personal lab tests. Antibody
screening tests check for protein the body produces within 2 to 8 weeks after HIV infection.
ELISA tests as they are known, are very accurate. Antibody/antigen combined tests are blood
tests. These can detect HIV earlier than any other kind. They check for P24 protein, part of
the virus which shows from 2 to 4 weeks after infection, and also check for HIV antibodies.
(CDC. 2022).
5) Valid (distinguishes diseased & non-diseased people)
All such tests, as discussed above, will make such distinction. In terms of accuracy both
antibody and antibody/antigen combined tests are the most accurate. These are performed in
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laboratory facilities. If the test result is positive, the laboratory will perform a follow-up test
to double-check. (CDC. 2022)
References:
Robert H. Friis. (2018) Epidemiology 101. 2nd edition. Burlington, Massachusetts. Jones &
Bartlett. USA
Ann Aschengrau, George R. Seage III (2020) Essentials of epidemiology in public health. Fourth
edition. Burlington, Jones & Bartlett Learning. USA
Bovbjerg, M. (2020). Foundations of Epidemiology. Corvallis, OR: Oregon State University.
Retrieved from https://open.oregonstate.education/epidemiology/
CDC. (2022). HIV screening. Retrieved from:
https://www.cdc.gov/hiv/clinicians/materials/screening.html

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Written Assignment, Unit 3

screening. This preliminary examination is aimed at identifying “unrecognized disease or

performed throughout pharmacies and drug stores, such as blood-pressure or cholesterol

screening proceeding is considered alongside disease surveillance as it happens in

STD’s patients or infectious diseases transmissible sexually or through blood. Moreover,

with risk factors. (Robert H. Friis. 2018)

Discussion of HIV screening

3) Produce minimal discomfort.

Both self-tests produce minimal discomfort.

5) Valid (distinguishes diseased & non-diseased people)

to double-check. (CDC. 2022)

edition. Burlington, Jones & Bartlett Learning. USA

Bovbjerg, M. (2020). Foundations of Epidemiology. Corvallis, OR: Oregon State University.

Retrieved from https://open.oregonstate.education/epidemiology/

CDC. (2022). HIV screening. Retrieved from:

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