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National HIV Testing Day -- Take the Test, Take Control

Today, June 27, is National HIV Testing Day (NHTD), initiated 19 years ago by the National Association of People with AIDS (NAPWA) and the U.S. Centers for Disease Control and Prevention (CDC) to raise awareness about HIV and encourage people to learn their status.

According to the CDC, 1 in 5 of the nearly 1.2 million people living with HIV in the U.S. do not know they are infected, and it is estimated that a majority of new cases are transmitted by individuals who are unaware they carry the virus. People who do not know they are HIV positive cannot be linked to care and start antiretroviral therapy, which is beneficial both for an individual's health and to prevent onward transmission.

"Knowing your HIV status matters now more than ever: Effective medications are available, and treatment leads to improved outcomes for the infected individual and decreased transmission to others," the HIV Medical Association (HIVMA) stated in a NHTD press release. "People who are diagnosed and treated early have better long-term health outcomes and minimize their risk of spreading the infection to others."

"Early access to expert HIV care prevents serious damage to a patient’s immune system and allows patients to live much longer, healthier lives," said HIVMA Chair Judith Aberg. "One of our most effective strategies for reducing HIV infections is to connect people with HIV to care early so that they can fully benefit from treatment and be less likely to transmit the virus to others."

Many HIV/AIDS advocates resisted routine testing in the early years of the epidemic when there were no good treatments and people who tested positive faced overwhelming discrimination. As better drugs became available, advocates began to promote voluntary testing, yet stigma and criminalization of people with HIV remain barriers for many people.

Since 2006 the CDC has recommended that all adolescents and adults should receive HIV tests as part of routine medical care.

"CDC supports testing as one of the most powerful HIV prevention tools we have. It is the pivotal first step in linking people to treatment, care, and prevention services," said Jonathan Mermin, director of the CDC's Division of HIV/AIDS Prevention, in a Greater Than AIDS press release. "CDC recommends all adults and adolescents be tested for HIV at least once as a routine part of health care and that those at increased risk -- including gay and bisexual men, injection drug users, or persons with multiple sexual partners -- be tested at least annually."

According to a recent report in the June 22, 2012, issue of Morbidity and Mortality Weekly Report, a study of more than 57,000 people who were newly diagnosed with HIV infection during 2006-2009 and had available testing history information found that 59% had previously had a negative test before testing positive.

Among those with available data about timing of prior tests, 24% tested negative within the past year, 12% did so 13 to 24 months before HIV diagnosis, 21% did so more than 24 months before testing positive, and 41% had no previous negative tests. People over age 50, heterosexual men and women, injection drug users, and African Americans were most likely to be diagnosed with HIV on their first test.

"The findings in this report provide insight into HIV testing patterns among persons diagnosed with HIV infection in the United States and underscore the need to enhance efforts to increase annual HIV testing for populations at high risk for HIV infection and to reduce the percentage of persons being diagnosed with HIV on their first test, particularly blacks/African Americans and injection drug users," the researchers concluded. The study also underlines the importance of frequent repeat testing for people who remain at risk.

Testing Initiatives

On June 26 the CDC announced a new initiative to expand HIV testing into pharmacies and retail clinics throughout U.S., which are increasingly used by people who lack comprehensive health insurance. In an effort to make testing more convenient and accessible, this 2-year pilot program -- which will start with 24 urban and rural pharmacies -- will provide a model for offering confidential rapid HIV tests as part of the standard services offered at community pharmacies and retail clinics.

"We know that getting people tested, diagnosed and linked to care are critical steps in reducing new HIV infections," said Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. "By bringing HIV testing into pharmacies, we believe we can reach more people by making testing more accessible and also reduce the stigma associated with HIV."

Walgreens and Greater Than AIDS -- a coordinated campaign to reach communities at high risk of HIV -- are teaming up with local health departments and AIDS organizations to offer free HIV testing at 46 storesin 20 cities nationwide from 3 pm to 7 pm on June 27-29.

The National Institute of Allergy and Infectious Disease (NIAID) "Test and Link-to-Care plus Treat" study(aka TLC-Plus or HPTN 065) is assessing the feasibility and effectiveness of an approach that includes promoting frequent HIV testing for men who have sex with men and others at increased risk, offering HIV tests in hospital emergency rooms and upon inpatient admission, using financial incentives to encourage newly diagnosed individuals to obtain medical care and those who begin treatment to maintain low viral load, and providing interactive computer-based counseling to help HIV positive people reduce their risk of transmitting the virus to others.

HIV Testing Resources

AIDSinfo National HIV Testing Day web page;

AIDS.gov National HIV Testing web page;

CDC National HIV Testing Day web page, which includes a map of local events;

CDC National HIV and STD Testing Resources(hivtest.cdc.gov), which lets users find testing sites by zip code;

NAPWA National HIV Testing Day web page;

KnowIt confidential text messaging service to help people find nearby HIV testing sites: send text with zip code to "KnowIt" (566948);

Follow #NHTD on Twitterfor news and other related information.

6/27/12

Sources

A Hernandez, J Prejean, M Doshani, et al. Previous HIV Testing Among Adults and Adolescents Newly Diagnosed with HIV Infection -- National HIV Surveillance System, 18 Jurisdictions, United States, 2006–2009. Morbidity and Mortality Weekly Report 61(24):441-445. June 22, 2012.

CDC. Innovative CDC Effort Expands HIV Testing into Pharmacies. Press release. June 26, 2012.

HIV Medical Association. Know Your Status: This HIV Testing Day, HIV Experts Urge Everyone to Get Tested. Press release. June 21, 2012.

NIAID. Research on Expanded HIV Testing and Linkage to Care. Fact sheet. June 19, 2012.

Kaiser Family Foundation. Walgreens and Greater Than AIDS Team Up with Health Departments and Local AIDS Service Organizations to Provide Free HIV Testing in Support of National HIV Testing Day. Press release. June 16, 2012.