March 2008 - While New York City may be home to national treasures such as the Statue of Liberty and the Metropolitan Museum of Art, it is also the epicenter of the HIV/AIDS epidemic in the United States. NYC has the highest AIDS case rate in the country with more AIDS cases than Los Angeles, San Francisco, Miami, and Washington D.C. combined.
The number of new HIV diagnoses in NYC has declined annually since 2001. However, a growing percentage of those diagnosed with HIV are concurrently diagnosed with AIDS, up from 22% in 2001 to 27% in 2005, which means that a higher proportion of people infected with HIV do not learn of their diagnosis until they are already sick with AIDS. Since the onset of AIDS can take an average of 10 years, infected persons who do not know they are sick are more likely to spread the virus to others and have missed the opportunity to begin treatment which could improve their health, extend their lives, and save the lives of others.
The New York City Department of Health and Mental Hygiene aims to make HIV testing a routine part of medical care to help reduce the spread of HIV/AIDS and help infected individuals receive treatment sooner. Unfortunately, many barriers exist to routinizing testing, particularly in the methods clinicians use to determine when to offer an HIV test.
Currently, HIV testing is based on risk, so health care providers offer tests either when patients ask for one or if patients indicate that they participate in high-risk behaviors, such as using intravenous drugs. One of the challenges to the current model of risk-based testing is that studies have shown that adults who engage in high risk activities often do not perceive themselves as at risk and therefore do not ask to be tested.
On November 13, 2007, the NYC Health Department hosted a conference to explore the barriers to voluntary testing from the perspective of health care providers. The conference was made possible by a grant from the Harry S. Black & Allon Fuller Fund to the Fund for Public Health in New York (FPHNY). The conference, titled "Putting the Pieces Together: Routinizing HIV Testing in New York City," was co-sponsored by the New York City Health and Hospitals Corporation, the New York State Department of Health AIDS Institute, and the New York/New Jersey AIDS Education and Training Center. Over 200 administrators, health care providers, HIV testing staff, health educators and social workers attended.
Conference activities included presentations and workshops which analyzed the challenges and rewards of routinizing HIV testing in a variety of health care settings. Conference evaluations indicated that participants overwhelmingly felt that the conference achieved its educational objectives of informing the provider and clinical community about the use and best practices of rapid testing, and providing a forum to discuss how to routinize testing. According to Dr. Monica Sweeney, Assistant Commissioner of the Health Department's Bureau of HIV/AIDS Prevention and Control, "This conference was one of the first steps in widespread dissemination of the change in guidelines, from risk-based to routine testing. We are delighted with the results."
To read more about reducing barriers to voluntary HIV testing, click here. |
