Despite national guidelines, private insurers, ER, federal and state agencies fail to routinely te...(aid Summit co-chair Dr. John G. Bartlett...),Health

Date:11/20/2008

aid Summit co-chair Dr. John G. Bartlett, of The Johns Hopkins University. "HIV testing started in 1985 when there was no treatment, a morbid death, an unrealistic fear of contagion and terrible stigma. Substantial barriers were developed to assure patients knew the consequences of testing. Now HIV is treatable, we have a test that takes minutes and costs ten dollars. Individuals benefit enormously from treatment, as does society."

Ongoing barriers to testing include obstructive policies by federal agencies and some states; a lack of funding, information, and trained staff; and the lack of a national reimbursement system for federal agencies. In addition, the people responsible for administering the test are not necessarily aware of the new guidelines and do not always support them.

For example, although numerous studies document that well over half of ER patients support routine testing, surveys of ER staff often show a majority oppose it. A survey of Emergency Department professionals from 40 institutions show the top two barriers as an increased burden on ER staff and lack of funding.

Individual Successes Point the Way Forward

Despite the barriers, Summit presenters described successes across a number of health care settings and jurisdictions.

A voluntary rapid HIV testing program in New York City jails increased testing from 6,500 to 25,000 inmates between 2004 and 2006. About 30 percent of men and 23 percent of the women who tested positive were previously undiagnosed. Of these, 90 percent were neither men who have sex with men (MSM) nor intravenous drug users, demonstrating the limited effectiveness of only testing those in high-risk groups.

ERs have experimented with ways to integrate testing in to the hectic pace of work. One Chicago hospital, for example, staffed its ER with two health educators, offering rapid testing to patients admitted for medical services. Over 15 months, nearly 2000 patien
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Contact: Katy Lenard klenard@burnesscommunications.com 202-494-2584 Forum for Collaborative HIV Research Source:Eurekalert

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