Expanded HIV Testing Pays Off: Studies

(HealthDay News) -- Making HIV screening routine in emergency rooms and at gay pride events expands the number of people getting tested and helps those who are HIV-positive get access to needed health care, new research found.

About one-quarter of the estimated one million people in the United States infected with the virus that causes AIDS don't know they have it. Consequently, they are at heightened risk for transmitting the virus to others, according to two reports published in the June 22 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

The reports come out just in time for National HIV Testing Day, June 27, and planned gay pride celebrations in many U.S. cities this weekend.

Study co-author Patrick Sullivan is chief of the behavioral and clinical surveillance branch, part of the CDC's division of HIV/AIDS Prevention. He said, "Routinely offering testing at emergency departments for people seeking care for other conditions is feasible and acceptable. The goal is to make testing available to as many people as possible."

"This is an important strategy to help people know their status," he said.

For the first report, researchers analyzed routine HIV testing that had been implemented in one hospital emergency department in Los Angeles, one in New York City and one in Oakland, Calif., in 2004 and 2005 as part of a CDC initiative.

Between January 2005 and March 2006, 186,415 people visited the emergency departments, 18.6 percent of whom (34,627) were offered rapid HIV tests. Nearly 60 percent (almost 21,000) of those offered agreed to be tested, and 9,365 received a rapid test.

Of those tested, 1 percent (97 patients) received a preliminary positive result for HIV infection, and 88 percent of those identified as HIV-positive were linked to appropriate care.

If only those persons reporting risky behaviors (male-to-male sexual contact, intravenous drug use, commercial sex work, or diagnosis of a sexually transmitted disease) had been offered testing, 48 percent of the people with newly diagnosed HIV infection would not have been tested, the study said.

These findings essentially paved the way for the CDC's revised recommendations in 2006 that call for HIV testing to become a routine part of medical services, using a voluntary "opt-out" approach.

For the second study, CDC researchers analyzed data from a survey of minorities who had attended gay pride events in nine U.S. cities from 2004 to 2006.

CDC representatives offered rapid HIV testing to survey participants who reported that they had not previously been diagnosed with HIV. Of 543 men surveyed, 133 agreed to be tested. Six percent (eight men) of those tested were HIV-positive. Four had had a negative test within the past year.

More than one-quarter of 229 participants had not seen a health-care provider within the past year and, of those who had, only 40 percent had been offered an HIV test.

The CDC sees HIV testing at gay pride events as part of a larger strategy to encourage testing among gay men. Testing in such settings is especially important to reach people who may not have regular access to health care, the CDC said.

Dr. Lisa Kudlacek Cornelius is an assistant professor of internal medicine with the Texas A&M Health Science Center College of Medicine and chairwoman of infection control/hospital epidemiologist with Scott & White Hospital in Temple. She said, "The important thing is to bring people into care sooner, before they have an AIDS-related illness."

With rapid testing, she added, "They have their answer within 20 minutes, but with testing, you also need counseling."

More information
Find out more about National HIV Testing Day, including where to get tested.