Expanded Testing: Rationale and Prioritization

Rationale

In accordance with the CDC recommendations, we encourage all clinical and non-clinical sites across the State of Pennsylvania to routinely offer HIV tests to all patients aged 13-64.  Justification for expanded HIV testing include:

  • Every 9.5 minutes, someone in the U.S. is newly infected with HIV.  Approximately 56,300 new cases occur annually
  • >1 million people in the U.S. are living with HIV. An estimated 20% are unaware they are infected
  • People who are unaware of their status are more likely to transmit HIV to others
  • “Predicting” who needs to be tested can be very subjective
  • Expanded testing decreases the stigma associated with HIV testing
  • It has become cost effective to screen for HIV

According to the most recent data collected by the CDC from 34 states, 38% of those diagnosed with HIV received an AIDS diagnosis within a year of their HIV diagnoses, and 45% had an AIDS diagnosis within 3 years of their HIV diagnoses. (MMWR, June 26, 2009 / 58(24);661-665). As progression to AIDS usually takes an average of ten years, early testing for HIV can potentially reduce morbidity and mortality, while lowering long-term health care costs.

Prioritization

We fully encourage and support all efforts to increase HIV testing services across Pennsylvania.  Due to limited resources, we have targeted our efforts to specific regions of Pennsylvania. In order to achieve our objective of reaching target populations with the highest burden of HIV disease, primarily racial/ethnic minorities (mainly African American & Hispanic) & higher transmission risk groups (mainly PWID & MSM), we identified three regions of need within Pennsylvania: South-West, South-Central, and South-East.

We are always looking to partner with healthcare facilities who serve a high proportion of these populations, have demonstrated commitment to the expanded testing concept, and have had prior ability to link individuals to HIV prevention and care services.

Map of Prioritized Regions & Existing PEHTI collaboration sites

The map below shows the distribution of PEHTI collaboration sites overlaid on prioritized regions [based on HIV morbidity by race/ethnicity and higher risk probable modes of transmission (IDU & MSM)]. As shown in the map state correctional institutions and STD clinics implementing opt-out HIV screening are located in many parts of the state outside the identified priority regions. To view a clearer larger image, please click on the image below.

pehti_providers_combo23