Will routine physical examinations detect HIV?

HIV screening items are usually not included in the default package of routine physical examinations.

The routine physical examination we usually talk about, whether it is an annual physical examination organized by the workplace or a basic physical examination package issued by oneself at the hospital, the core coverage is items such as blood routine, liver and kidney function, blood sugar and blood lipids, chest X-ray, and ultrasound to check for common basic diseases. It is aimed at high-prevalence health problems such as high blood pressure, hyperlipidemia, and fatty liver. AIDS is a special infectious disease screening and is not included in the basic coverage.

Some people may find it strange that if you draw several tubes of blood at one time, can't you just test it at the same time? You may have misunderstood the working logic of the laboratory department. The testing items are all in one-to-one correspondence with the order, just like when you go to a restaurant to order food, whichever dish you order will be cooked. Unordered dishes will not be served to you even if the ingredients are prepared. If there is no application form for HIV testing, even if the blood sample is placed there, the laboratory department will not do more of this, otherwise it will violate the relevant regulations on privacy protection. What's more, the AIDS screening test tests HIV antibodies, which is a special immune test. It has different reagents and procedures from routine blood tests, liver and kidney function tests, and there is no way to "pass on" the test.

I met a young man before who was so panicked after having high-risk behavior a while ago that he just happened to catch up with the company for a physical examination. I thought I would save myself from having to take the test alone. I waited for a week to get the report and searched it over and over three times. It even included items for hepatitis B, but only for those without AIDS. When I went to ask the doctor, I found out that the regular package did not include this at all. You have to pay for the test separately and sign an informed consent form. All results are received separately and sealed, and will not be put together with other physical examination reports, in order to protect privacy to the greatest extent.

Of course, not all physical examinations do not check for AIDS. Preoperative examinations before surgery, blood screening before blood donation, and follow-up physical examinations after occupational exposure all list HIV screening as required items. However, these are special physical examinations for specific scenarios and cannot be regarded as "routine physical examinations" in our general understanding.

In recent years, there has been a lot of discussion about whether to include HIV screening as an optional item in routine physical examinations. Many experts in the public health field believe that nearly 30% of people infected with HIV do not know their infection status. If they can voluntarily test during physical examinations, it can greatly increase the rate of early diagnosis. After all, as long as AIDS is detected early and prescribed medication, they can basically live like ordinary people.； However, many people are worried that the discrimination against AIDS in society has not been completely eliminated. If the information is leaked about routine physical examinations, infected people may encounter unfair treatment in employment and life, which will make high-risk groups resist physical examinations.

If there is a real need for testing, there is no need to wait for a regular physical examination. Centers for Disease Control and Prevention in various places can provide free HIV screenings. The entire process is confidential, and the results will not be recorded in the regular physical examination files. It is much more convenient than getting a physical examination on your own.