Source: Baltimore Sun, Washington Post, Miami Herald
Many people infected with HIV are not aware of their status, partly because testing for the virus is not yet as widespread as government health officials recommend.
The federal government recommended two years ago that patients in emergency rooms and doctors' offices be routinely tested for the virus that causes AIDS, but the advice is generally not being followed, according to a large number of studies presented this week at a conference in Arlington.
Those who do not know they have the virus are responsible for transmitting 50 percent to 70 percent of new sexually transmitted infections, researchers at the conference said.
"It's a call to action that the test will be offered on a more regular basis," said Dr. John G. Bartlett, chief of infectious diseases at the Johns Hopkins School of Medicine and co-chairman of the meeting.
Only about 5 percent of patients with evidence of serious illness are being routinely tested in hospital emergency rooms for HIV, said Veronica Miller, director of the Forum for Collaborative HIV Research, an independent public-private partnership based at the George Washington University School of Public Health and Health Services, according to the Washington Post.
"HIV is a life-threatening disease that is so grossly underdiagnosed and undertreated in this country," Miller said in a briefing on the two-day Summit on HIV Testing.
''It's crucial to understand how important routine HIV testing is at every level of American society so everyone knows their status; it's the first step in controlling the HIV epidemic,'' she explained.
Researchers at the forum said last week that testing is the key to ending the epidemic in the United States. Of the nation's estimated 1.1 million people living with HIV, one in five do not know it and those who are being diagnosed are learning the news too late, the group said, according to Baltimore Sun.
The research presented at the conference suggests that routine testing, if implemented, would detect the infection at a much earlier stage in many patients.
In 2006, nearly 25 percent of the 60,000-plus Americans who had newly contracted the HIV virus were not aware of it, and thus weren't getting treatment or protecting their sexual partners. Today it's 21 percent -- an improvement, but nowhere near enough, said speakers at the conference, according to Miami Herald.
Emergency rooms around the country tested patients at a rate of 3.2 per 1,000 visits, according to 2006 data shared at the conference by Dr. Richard Rothman, associate professor in Hopkins' emergency medicine department: "There are many missed opportunities in recognizing patients earlier in the course of their illness."
Dr. Kenneth H. Mayer, director of the Brown University AIDS Program, said many of the people who are infected with HIV do not consider themselves high risk and are unlikely to seek testing, Baltimore Sun reports. For instance, African-American women, who have disproportionately high rates of HIV, are often infected in the context of a monogamous relationship, he said.
At Hahnemann University Hospital in Philadelphia, where trained counselors offered rapid testing to emergency room patients in an interaction that lasted slightly more than five minutes, 83 percent of patients said yes. Half were women, 80 percent were black, and the average age was 36. About one-quarter had never been tested, and 0.7 percent were infected, Washington Post reports.
In Baltimore, the city stopped requiring written consent for HIV testing this year, according to Baltimore Sun. "Many felt that the consent was stigmatizing in itself; you don't need a consent form for other blood tests," said Dr. Laura Herrera, chief medical officer for the city's Health Department. "The goal is to normalize it and remove a barrier to HIV testing so the perception is that HIV testing isn't any different than any other testing."
In Florida, for example, between October 2007 and July 2008, several new programs in the state tested 43,481 individuals for HIV, identifying 1,042 people infected, a report presented at the conference said. But the goal is to test 150,000 a year, Miami Herald reports.
Until recently, it took two weeks to get the results of HIV tests, explained Dr. Jose Castro, a University of Miami infectious disease doctor and medical director of Miami-Dade's STD clinics. Because of the delay, many patients failed to come back for the results, Castro explained to Miami Herald. Now the clinics have instant HIV-testing kits.
"They can learn their status before they leave," Castro said, "and we can get them into treatment."
Miami-Dade's four sexually transmitted disease clinics test about 16,000 patients a year for HIV, Castro said.
New HIV testing sites have been set up in nine major Florida hospitals, three community health centers, 10 clinics for sexually transmitted diseases and 10 correctional facilities, according to a summary of a paper prepared by Tom Liberti, chief of the Bureau of HIV/AIDS of the Florida Department of Health. The summary did not list the hospitals or health centers and the state agency did not have information about them.
Source: Routine HIV testing not performed, forum says | Baltimore Sun
Many People Disregard Advice to Get HIV Tests, Studies Show | Washington Post
Many with HIV unaware | Miami Herald