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CDC touts success of HIV testing program

Sunday June 26, 2011
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A three-year, $111 million program to expand access to HIV testing in 25 of the U.S. areas most affected by HIV has provided nearly 2.8 million HIV tests and diagnosed 18,432 individuals who were previously unaware of their HIV infection, according to the U.S. Centers for Disease Control and Prevention.

In addition, of the newly diagnosed individuals for whom follow-up data was available, three-quarters were successfully linked to HIV care as part of the CDC’s Expanded Testing Initiative.

Between October 2007 and September 2010, the CDC provided funding to state and local health departments to support routine HIV testing, primarily in healthcare settings such as EDs, sexually transmitted disease clinics and doctors’ offices, as well as in select community venues. The effort focused primarily on reaching African-Americans, who are more severely affected by HIV than any other race or ethnicity in the United States.

Based on preliminary indications of the program’s success, in October 2010 the CDC expanded the focus and funding of the initiative. The CDC now provides funding to 30 areas, up from 25, to reach several populations heavily affected by HIV, including African-Americans, gay and bisexual men, Latinos and injection drug users.

“Ensuring that all Americans know their HIV status is critical to reducing new infections and putting an end to the epidemic,” Kevin Fenton, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, said in a news release. “These results demonstrate that the nation is making steady progress toward that vision. But more than half of U.S. adults [ages] 18 to 64 still have never been tested for HIV, and our work is far from over.”

The CDC launched the Expanded Testing Initiative to support its 2006 Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health Care Settings. The recommendations, which call for HIV testing to become a routine part of healthcare for all American adults and adolescents, are designed to remove key barriers to testing in healthcare facilities.

The initiative initially targeted African-Americans, and was particularly successful in this population. During the three-year period, African-Americans accounted for 60% of tests performed (1.4 million) and 70% of new HIV diagnoses (11,638), and were 1.6 times more likely to test positive for HIV than whites or Hispanics (0.8% and 0.5% respectively), reflecting long-standing disparities in the U.S. HIV epidemic.

Overall, 90% of tests were provided in healthcare settings, accounting for 81% of new HIV diagnoses. EDs were particularly important venues for HIV testing, accounting for 30% of all tests and 32% of all previously undiagnosed infections.

CDC data show that while African-Americans represent 14% of the U.S. population, they account for nearly half of annual new HIV infections. Research shows that a range of social and environmental factors — including lack of access to healthcare, poverty, higher rates of STDs, stigma and homophobia — place communities of color, especially African-Americans, at greater risk for HIV, according to the CDC.

Like other racial and ethnic groups, as many as one-third of African-Americans with HIV are diagnosed late in the course of their infection, when treatment is less effective and after many opportunities to prevent further spread of the virus have been missed.

In addition to focusing the initiative on African-Americans, the CDC also took steps to ensure that resources were directed to reach other populations at highest risk for HIV. Health departments in the 25 participating jurisdictions were asked to utilize local epidemiological data to identify and prioritize specific venues serving hard-hit communities.

“These results are exciting and encouraging,” Jonathan Mermin, MD, director of the CDC's Division of HIV and AIDS Prevention, said in the news release. “They remind us that high-impact prevention works. With collaboration and focus on those who are hardest hit by this disease, we are making great strides in the fight against HIV.”


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