In 2015, an estimated 15% of persons living with HIV were unaware of their infection, but they accounted for approximately 40% of annual HIV transmissions in the United States. Although the US Centers for Disease Control and Prevention (CDC) recommends at least annual HIV testing for persons at high risk, including men who have sex with men (MSM) and persons who inject drugs (PWID), many of those persons are either not offered or do not receive HIV testing when visiting clinicians. We estimated the percentages of MSM and PWID unaware of their HIV infection with missed opportunities for testing and diagnosis in clinical settings.
Substantial numbers of MSM and PWID unaware of their HIV infection reported missed opportunities for earlier diagnosis. Approximately half of unaware MSM and PWID who reported not having been tested in the past year reported not being offered HIV testing by any clinician despite having seen one. Many HIV infections among MSM and PWID could be diagnosed sooner if HIV testing were more frequently offered during clinical visits.