North Carolina: Routine HIV Testing Urged

North Carolina is in the vanguard for its efforts to reduce social barriers to HIV screening, say state epidemiologists. Two years ago, CDC recommended HIV screening for all patients ages 13-64 in health care settings as a means to destigmatize testing, link infected patients to care earlier, and reduce onward transmission.

"Twenty-five to 30 percent of the people living with HIV don't know they're infected," said Dr. Peter Leone, the medical director for the state HIV/STD prevention and care branch and a University of North Carolina-Chapel Hill associate professor. "In North Carolina, about 40 percent of our [HIV-positive] folks, when they first come in, have AIDS."

"We believe that it's critical to identify these folks to improve their own health," Leone said. "We're 27 years into this epidemic, and we're getting people very late. They don't do as well with therapy when they're coming in late."

For the past year, Piedmont Health Services in Carrboro has routinely offered free rapid HIV screening for patients ages 13-64, and more than 70 percent agreed to it. Among over 4,000 patients screened, six tested HIV-positive.

North Carolina's count of new HIV cases has risen to nearly 1,700 a year from 1,500 five years ago, but statisticians cannot tell whether the increase is due to more infections or is the natural byproduct of more testing.

"The resistance has been there more in the past in ‘Why are you asking my kid about HIV testing?'" Leone said. "When parents are told this is something we offer to everyone, and this is national, we get very little resistance. We want to get to a point where screenings are as routine as blood-pressure tests. Your clinician doesn't say to you, ‘You don't look like you have high blood pressure, so let's don't check it today."

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