Possible Screening Applications

By usual laboratory standards, the EIA assay with WB confirmation has very high sensitivity and specificity. It is therefore tempting to use this test: (1) To track the progress of the epidemic by estimating seroprevalence in various subgroups; (2) to prevent the spread of HIV infection by identifying infected individuals and counselling them on how to reduce the risks of transmission to others; and (3) to identify infected individuals so as to facilitate earlier and more effective treatment. Surveys to estimate seroprevalence (Chapter 3) are limited mainly by the willingness of persons to be screened for HIV rather than by the accuracy of these tests. Volberding (1989) has emphasized the importance of HIV testing for proper management of the HIV infected patient. Establishing the diagnosis of HIV infection allows the physician to advise the patient as to prognosis, plan further monitoring of the patient's immune status, and institute therapy in a timely manner rather than after serious complications have occurred. The most controversial proposals for using assays concern screening populations for prevention activities, though efforts to screen donated blood products (Section 6.4) are generally accepted.

The controversy about screening populations for prevention activities derives from two concerns. First, an appreciable number of false positive results may occur, especially when screening populations with low prevalence of HIV infection, resulting in needless anxiety and other possible adverse consequences in an uninfected individual. Second, whether or not the test positive individual is infected, he or she may be adversely affected by social ostracism or exclusion from insurance or employment opportunities if the test result is revealed.

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Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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