Daniel Engber notes that “at least 18 percent of HIV-positive Americans don’t realize they’re infected, and in developing nations, that rate is almost three times higher.” He advocates for near universal testing:
The therapies we have are already good enough to win the war on AIDS, but they can only score that victory if we reach more infected people quickly. To catch cases while they’re still developing, we’ll need a much bigger net—a way to screen for HIV that’s close to universal, and a means of starting treatment right away. It used to be that we needed better drugs. Now we need better diagnoses.
What this could accomplish in the US:
A group at Stanford has figured that screening all Americans for HIV at least one time in their lives (along with yearly tests for those at higher risk of contracting the disease) could prevent 212,000 new infections over the next 20 years. Such a program would not be cheap, of course, but the researchers estimate that it would buy the equivalent of an extra year of healthy living for every $25,000 spent. That rate of return matches up with those achieved from screening for breast cancer or type 2 diabetes.