A Health Education Specialist with the Centers for Disease Control and Prevention (right), counsels a participant after receiving a free HIV test from AID Atlanta as part of National HIV Testing Day. (Image: AP)

A new report from the US Centers for Disease Control shows that, while detection rates are improving, a surprising number of Americans live with HIV for a protracted period of time before it gets diagnosed—including patients who’ve visited their doctor.

In 2015, the average time it took a person in the US to get a diagnosis after contracting an HIV infection was about three years, according to a new Vital Signs report put out yesterday by the CDC. Back in 2011, that statistic was three years and seven months, so detection rates are improving.

“These findings are more encouraging signs that the tide continues to turn on our nation’s HIV epidemic,” said CDC director Brenda Fitzgerald in a statement. “HIV is being diagnosed more quickly, the number of people who have the virus under control is up, and annual infections are down.”

But while things are steadily improving in this area, there’s still plenty of room for improvement. In 2015, nearly 40,000 people in the United States received an HIV diagnosis. Of them, half had lived with the disease for three years or more before they knew it, and a quarter lived with the disease for seven years before they finally got a diagnosis. One in five saw their HIV advance to the most advanced stage—AIDS—before a diagnosis. In 2014, around 1.1 million people in the US had HIV.

When it comes to HIV, early detection is critical—both in terms of prevention and treatment. Medicines allow people who have the virus to live a long and healthy life. And by taking the appropriate precautions, infected individuals can actively protect their partners from contracting HIV. As the CDC points out, two out of every five new HIV infections are caused by a person who didn’t even realize they had the disease.

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In terms of recommendations, the CDC says doctors should test all patients between the ages of 13 to 64 for HIV at least once in their lifetime. Patients at higher risk should be tested at least once a year (people at high risk include sexually active gay and bisexual men, people who inject drugs, and heterosexuals who have sex with someone who’s at risk for or has HIV), and it’s not unreasonable for doctors to test some high risk patients every three to six months.

“Ideally, HIV is diagnosed within months of infection, rather than years later,” said Eugene McCray, director of CDC’s Division of HIV/AIDS Prevention, in a statement. “Further increasing regular HIV testing and closing testing, diagnoses and treatment gaps is essential to stopping HIV in our communities.”

Encouragingly, the new report shows that the percentage of people at increased risk for HIV who reported getting an HIV test during the previous year has gone up—but the CDC says too few are being tested. Patients who said they didn’t get an HIV test during the past year included nearly 30 percent of gay and bisexual men, 42 percent of people who injected drugs, and nearly 60 percent of at-risk heterosexuals. Discouragingly, seven in 10 people at high risk visited their healthcare provider during the past year but weren’t administered an HIV test. The CDC is trying to reduce these “missed opportunities.”

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The CDC also discovered that the time it takes to get diagnosed varies by risk group and by race/ethnicity. Amongst those who inject drugs, it takes about five years for heterosexual males, and about 2.5 years for heterosexual females, to get diagnosed. It takes, on average, about three years for gay and bisexual men to get an HIV diagnosis. White Americans get diagnosed after about two years, African Americans and Latinos around three years, and Asian Americans around four years.

As the CDC points out, it’s important for at-risk individuals to get tested often, but healthcare providers need to do their part as well. “Talk to all your patients about HIV. Tell them HIV testing is a routine part of a patient’s healthcare,” writes the CDC. “Have the conversation about HIV risk. Don’t assume you know a patient’s risk.”

[CDC Vital Signs]