HIV Testing Project Discovers 18,000 New Cases

A CDC initiative to expand HIV testing and link those infected to care resulted in more than 18,000 new diagnoses, the agency reported Thursday. Launched in 2007, the three-year, $111 million Expanded HIV Testing Initiative operated in 25 jurisdictions with high HIV prevalence. Health departments chosen as EHTI partners were required to target at least 80 percent of efforts on opt-out HIV screening in high-morbidity clinical settings; they had the option of directing up to 20 percent of efforts toward innovative testing programs for high-risk populations, such a social networking approaches for men who have sex with men (MSM).

In the program, 2.8 million HIV tests were conducted, and 29,503 (1.1 percent) were positive, including 18,432 previously undiagnosed cases. Blacks were a particular focus of EHTI, representing about 60 percent of those tested and 70 percent of the new diagnoses. Nearly three-quarters of those newly diagnosed were men. In the screening, men were more than twice as likely as women to test HIV-positive.

Clinical settings comprised at least 75 percent of testing venues and 90 percent of all tests. About 30 percent were emergency departments, 21 percent STD clinics, and 17 percent community health centers. Community-based organizations conducted about 10 percent of tests, and their rate of positivity was about twice that found in medical settings.

Of those testing positive: 93 percent received their results; 78 percent were linked to medical care; and 83 percent were referred to partner notification services.

EHTI is now expanding to include 30 states and cities with about $50 million in annual support for targeted testing, said Dr. Jonathan Mermin, director of CDC's Division of HIV/AIDS Prevention. EHTI will focus on African Americans, Hispanics, injection drug users, and MSM.

"It is the job of the health care system to make HIV testing as routine as cholesterol screening," Mermin said.

The full report, "Results of the Expanded HIV Testing Initiative -- 25 Jurisdictions, United States, 2007-2010," was published in Morbidity and Mortality Weekly Report (2011;60(24):805-810).

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