IDSA: Outpatient HIV Testing Among Vets Low – MedPage Today
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
- Note that this study in the VA health system shows that HIV testing is occurring at low rates -- even in areas with established high HIV prevalence.
Of the 5.7 million outpatients seen in the VA health system in 2009, a mere 9.2% had ever been tested for HIV -- and just 2.5% of VA outpatients were tested for HIV in 2009 -- researchers reported at the annual meeting of the Infectious Diseases Society of America.
"We don't know why these testing levels are so low, but they are even low in areas where HIV has a large prevalence," said Meredith Welch, MD, an infectious disease officer at the Veteran Affairs Medical Center/George Washington University Medical Center, Washington.
For example, in the District of Columbia where HIV infection prevalence is 1,402.4/100,000, only about 21.6% of VA outpatients have ever been tested for HIV.
In New York, where the prevalence of HIV is 777.4/100,000, just 11.8% of people in the VA health system have ever been tested for HIV.
In places where HIV prevalence is low, such as Utah with a prevalence of 105.2/100,000, just 2.7% of outpatients in the Veterans Affairs facilities there have been tested for HIV.
"The Centers for Disease Control and Prevention has recommended HIV testing for all persons aged 13-64 or pregnant women since 2006," Welch told MedPage today at her poster presentation. "The federal law requiring written informed consent for HIV testing with pre- and post-test counseling within Veterans Affairs was repealed in 2008," she added.
Despite removal of these barriers to HIV testing, there still appears to be a slow uptake of testing within the VA system -- which is responsible for providing health care for 67 million Americans, she said.
Welch suggested that her study could act as a baseline for future studies that will determine how well the VA health system is doing in testing for HIV.
"There may still be some stigma involved with HIV that prevents physicians from asking patients to undergo an HIV test," she said.
"Primary care physicians haven't been getting use to the idea of HIV testing," said Joel Ernst, MD, professor of medicine at the NYU Langone Medical Center in New York City. "I think that one of the barriers to HIV testing is the stigma associated with the disease. Previously when there was little that could be done to treat HIV, physicians and subjects were reluctant to be tested," he remarked.
Ernst told MedPage Today that with the greater number of available options to treat HIV infection today it's important to test and identify infected individuals so they can receive treatment.
Welch and her co-authors had no disclosures.
Ernst had no disclosures.
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