New York Times Examines Pilot HIV Testing Program in Emergency Departments
The New York Times on Sunday examined a CDC pilot program that began Dec. 1, 2008, at three Connecticut hospital emergency departments and provides no-cost HIV testing to patients. Connecticut is one of 26 states participating in the program -- which offers testing regardless of whether HIV symptoms are present -- at EDs, community health centers and clinics for sexually transmitted infections.
The hospitals involved in the program will conduct routine HIV testing for a two-year period, after which the program might be expanded to other hospitals. According to the Times, CDC in 2006 revised its guidelines to recommend routine HIV testing for patients ages 13 to 64. CDC estimates that about 25% of the 1.1 million people living with the virus in the U.S. are unaware of their HIV status. Steven Aronin -- medical director of the Infectious Diseases Clinic at Waterbury Hospital, which is participating in the program -- said Connecticut has a disproportionate number of people living with HIV/AIDS and ranks fifth nationwide in the number of cases per capita. Aronin said cities such as Bridgeport, New Haven and Waterbury have the most HIV cases, with Waterbury having as many as 1,200 HIV-positive residents, 300 of whom are unaware of their status. The other two Connecticut hospitals involved in the program are Yale-New Haven Hospital and Lawrence & Memorial Hospital in New London, Conn.
According to the Times, the traditional role of EDs has been to provide "triage for the sick and injured and not to act as testing facilities" for STIs. However, the Times reports that some physicians have said that role might "have to change as [EDs] become the only place the uninsured and low-income patients ever have contact with physicians." Some physicians have been "skeptical" of adding STI testing to the workload of EDs, which are already overcrowded, but physicians involved in the pilot program are "optimistic it will work," the Times reports. Chris Andresen, a manager with Connecticut's Department of Public Health's AIDS and chronic disease unit, said that 20 people who were unaware of their HIV status have tested positive in the last year through the program, which has already been operating in the state through the same federal funding as the pilot program. He said, "The early intervention is key. If they find out early, they can stay healthier longer and not transmit it to others" (Gordon Fox, New York Times, 1/4).