NHAS Goal, Strategy in Action: HIV Testing Innovations

 

Strategy in Action:

‘ HIV ‘ Testing Innovations Contribute to NHAS Goal

February 1, 2012

By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS Policy, U.S. Department of Health and Human Services

Dr. Ronald Valdiserri

With an estimated 20 percent of people living with HIV in the United States unaware of their status, strengthening our HIV testing efforts will be key to achieving the goals of the National HIV/AIDS Strategy (NHAS). Fortunately, many innovative HIV testing efforts are underway in communities across the country.

HIV testing is integral to HIV prevention, treatment, and care. Knowledge of one’s HIV status is important for preventing the spread of disease. Studies show that individuals who learn they are infected with HIV take active steps to reduce the likelihood of transmitting the virus to their partners. Early diagnosis of HIV helps to ensure that people living with the virus are linked into care and receive life-saving treatment. And recently we’ve learned that antiretroviral treatment can also help to prevent the further spread of HIV. Therefore, the NHAS aims to increase, by 2015, from 79 percent to 90 percent the percentage of people living with HIV who know their serostatus (from 948,000 to 1,080,000 people).

From Maine to California, health departments, community-based organizations, substance abuse and mental health programs, health care providers, hospitals, and others are implementing novel and effective approaches to HIV testing to help contribute to this important outcome. Examples we’ve heard about recently include:

• HIV Screening Offered at the Department of Motor Vehicles – An innovative example of the Strategy’s call for greater collaboration among government service providers is underway in Washington, DC, where HIV testing has been offered at the Department of Motor Vehicles for the past year. While waiting to get a driver’s license, temporary tags or other services, motorists visiting the Department of Motor Vehicles service center in the nation’s capital can get a free HIV test. This innovative collaboration between the DMV and the DC Department of Health (DOH) has tested more than 5,000 people since the program started in a single location in October 2010. According to Family and Medical Counseling Service Inc., the non-profit group that runs the program under a grant from DOH, between 25 and 35 people get tested every day, and anyone who is tested gets $7 off his or her DMV services. If someone tests positive, the nonprofit offers a ride to its office where staff can set up counseling and a doctor’s appointment. Building on the success of the DMV effort, officials expanded the program in late 2011 to offer testing at an office where Washington residents register for food stamps, Medicaid, and other government assistance. The same nonprofit will run the program there, offering as an incentive a $5 gift card to a local grocery store.

• Testing at Community Activities – In Pine Ridge, South Dakota, the Oglala Sioux tribe partnered with its local Indian Health Service facility to increase the availability of HIV screening in nonclinical, community-based settings. An experienced and well-regarded public health nurse has taken HIV testing to events and venues where there may not normally be a health-related activity. Over the past year, this locally initiated program has offered confidential HIV testing at community potlucks, rodeos, basketball games and Pow Wows. Bringing HIV testing to nonclinical settings has allowed them to reach community members who may not be in regular health care, including young people, and provide them with HIV education and the opportunity for confidential HIV testing.

• Promoting the HIV-STD Link and Encouraging Screening – Responding to a recent special surveillance report indicating a 23% increase in the number of primary and secondary syphilis cases in Chicago and a documented high rate of HIV-syphilis co-infection especially among MSM, the Chicago Department of Public Health recently launched the “Get Tested Chicago ” campaign to encourage individuals to get tested for HIV and other Sexually Transmitted Infections (STI), including syphilis and, if diagnosed, to get into care. The public awareness campaign includes targeted billboards, radio public service announcements (PSAs), and bus advertisements aimed at early detection, testing and awareness. The campaign makes the link between syphilis, as well as other sexually transmitted infections, and HIV. It notes that studies have repeatedly demonstrated that people are more likely to become infected with HIV when other STDs are present. Moreover, it informs Chicagoans that if a person is HIV-positive, or if the immune system is weakened for any reason, syphilis (and other STIs) may progress faster and do more damage to the body.