22 June 2007

Routine HIV tests vindicated

Making HIV screening routine in emergency rooms expands the number of people getting tested and helps those who are positive get access to needed health care, new research finds.

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 finds.

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 US Centres for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Study co-author Patrick Sullivan is chief of the behavioural 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."

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

For the first report, researchers analysed routine HIV testing that had been implemented in one hospital emergency department in Los Angeles, one in New York City and one in Oakland, California, 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.

48% may have been missed
If only those persons reporting risky behaviours (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 analysed data from a survey of minorities who had attended gay pride events in nine US 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.

Bring people into care sooner
Dr Lisa Kudlacek Cornelius is an assistant professor of internal medicine with the Texas A&M Health Science Centre 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 counselling." – (HealthDayNews)

Read more:
HIV/Aids Centre

June 2007


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Dr Sindisiwe van Zyl qualified at the University of Pretoria before working for an HIV/AIDS NPO in Soweto for many years. She was named one of the Mail & Guardian's Top 200 Young South Africans in 2012.

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