[Table, Routine Screening and Primary Prevention]. - Comprehensive Primary Care for Adults With HIV

Table 5: Primary Prevention for Adults With HIV
Type	Recommended Guideline(s)	Comments
Tobacco smoking	USPSTF: Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions (2021)	USPSTF: Screen all adults for tobacco use. Recommend cessation. Provide behavioral interventions and FDA-approved pharmacologic therapy. Resources: Millionhearts.hhs.gov: Protocol for Identifying and Treating Patients Who Use Tobacco Identifying and Treating Patients Who Use Tobacco: Action Steps for Clinicians Tobacco Cessation Change Package
Unhealthy alcohol and drug use	NYSDOH AI: Substance Use Screening and Risk Assessment in Adults (2020)	NYSDOH AI: Screen all adults for alcohol, tobacco, and drug use. Assess level of use and treat as indicated. Laboratory screening is not recommended. Resources: USPSTF: Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions (2018) NYSDOH AI: Substance Use Harm Reduction in Medical Care, Treatment of Alcohol Use Disorder, and Treatment of Opioid Use Disorder
Cardiovascular disease	USPSTF: Aspirin Use to Prevent Cardiovascular Disease: Preventive Medication (2022) Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication (2022) Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Behavioral Counseling Interventions (2022)	Resources: American College of Cardiology ASCVD Risk Estimator Plus Characteristics, Prevention, and Management of Cardiovascular Disease in People Living With HIV: A Scientific Statement From the American Heart Association
Depression	USPSTF: Screening for Depression in Adults (2016)	USPSTF: Screen for depression, with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. Resources: PHQ-2 PHQ-9 C-SSRS
Domestic violence	USPSTF: Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: Screening (2018)	Screen for domestic violence, including intimate partner violence, child abuse, and elder abuse.
Sexually transmitted infections	USPSTF: Sexually Transmitted Infections: Behavioral Counseling (2020)	USPSTF: Provide behavioral counseling for all sexually active adults and adolescents. Include discussion of appropriate vaccinations.
Neural tube defects in pregnancy	USPSTF: Folic Acid for the Prevention of Neural Tube Defects: Preventive Medication (2017)	USPSTF: Folic acid supplementation is recommended for individuals who are planning or capable of pregnancy.
Breast cancer	USPSTF: Breast Cancer: Medication Use to Reduce Risk (2019)	USPSTF: Risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors are recommended for women who are at increased risk of breast cancer and at low risk of medication-related adverse events. Routine preventive medication is not recommended for women who are not at increased risk. Note: This committee advises clinicians to screen for breast cancer in transgender and transfeminine men and cisgender females.
Skin cancer	USPSTF: Skin Cancer Prevention: Behavioral Counseling (2018)	USPSTF: Counsel patients to minimize ultraviolet radiation.
Falls	USPSTF: Falls Prevention in Community-Dwelling Older Adults: Interventions (2018)	USPSTF: Exercise interventions are recommended for adults ≥65 years old who are at increased risk for falls. Note: This committee advises clinicians to include osteoporosis screening.

Table 5: Primary Prevention for Adults With HIV

Type

Recommended Guideline(s)

Comments

Tobacco smoking

USPSTF: Tobacco Smoking Cessation in Adults, Including Pregnant Persons: Interventions (2021)

USPSTF:
- Screen all adults for tobacco use.
- Recommend cessation.
- Provide behavioral interventions and FDA-approved pharmacologic therapy.
Resources: Millionhearts.hhs.gov:

Unhealthy alcohol and drug use

NYSDOH AI: Substance Use Screening and Risk Assessment in Adults (2020)

NYSDOH AI:
- Screen all adults for alcohol, tobacco, and drug use.
- Assess level of use and treat as indicated. Laboratory screening is not recommended.
Resources:
- USPSTF: Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions (2018)
- NYSDOH AI: Substance Use Harm Reduction in Medical Care, Treatment of Alcohol Use Disorder, and Treatment of Opioid Use Disorder

Cardiovascular disease

USPSTF:

Resources:

Depression

USPSTF: Screening for Depression in Adults (2016)

USPSTF: Screen for depression, with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
Resources:

Domestic violence

USPSTF: Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: Screening (2018)

Screen for domestic violence, including intimate partner violence, child abuse, and elder abuse.

Sexually transmitted infections

USPSTF: Sexually Transmitted Infections: Behavioral Counseling (2020)

USPSTF: Provide behavioral counseling for all sexually active adults and adolescents.
Include discussion of appropriate vaccinations.

Neural tube defects in pregnancy

USPSTF: Folic Acid for the Prevention of Neural Tube Defects: Preventive Medication (2017)

USPSTF: Folic acid supplementation is recommended for individuals who are planning or capable of pregnancy.

Breast cancer

USPSTF: Breast Cancer: Medication Use to Reduce Risk (2019)

USPSTF:
- Risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors are recommended for women who are at increased risk of breast cancer and at low risk of medication-related adverse events.
- Routine preventive medication is not recommended for women who are not at increased risk.
Note: This committee advises clinicians to screen for breast cancer in transgender and transfeminine men and cisgender females.

Skin cancer

USPSTF: Skin Cancer Prevention: Behavioral Counseling (2018)

USPSTF: Counsel patients to minimize ultraviolet radiation.

Falls

USPSTF: Falls Prevention in Community-Dwelling Older Adults: Interventions (2018)

USPSTF: Exercise interventions are recommended for adults ≥65 years old who are at increased risk for falls.
Note: This committee advises clinicians to include osteoporosis screening.

From: Comprehensive Primary Care for Adults With HIV

Cover of Comprehensive Primary Care for Adults With HIV

Comprehensive Primary Care for Adults With HIV [Internet].

Dyer M, Kerr C, Fine SM, et al.

Baltimore (MD): Johns Hopkins University; 2022 Dec.

Copyright © Johns Hopkins University Clinical Guidelines Program 2000-2024. The Clinical Guidelines Program, a collaborative effort of the NYSDOH AI and the Johns Hopkins University School of Medicine, Division of Infectious Diseases, encourages the use, reproduction, and distribution of original documents and related graphics from this program website accompanied by a full citation of source that includes: Author(s). Committee. Title. Date of publication. Full URL. Date accessed. Links to pages on this Clinical Guidelines Program website are also encouraged and may be created without seeking permission. Requests to adapt material, i.e., to change or alter in any way material from this website for inclusion in another publication, should be sent to aiguidelines@jhmi.edu. Please include detailed information about the intended use and desired adaptations.

This book is licensed under the terms of the Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY-NC-ND 3.0).

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.