U.S. Veterans Affairs Increases HIV Screening

Streamlined testing procedures have helped more than double the number of vets getting screened for HIV in the Veterans Health Administration (VHA) system, according to a report presented at the recent American Conference on Treatment for HIV in Denver. The data and conclusions are considered preliminary until publication after peer review.

In 2009, federal law was amended to eliminate the requirement that the Department of Veterans Affairs document written informed consent to HIV testing, as well as mandatory pre- and post-test counseling. In addition, the VA incorporated electronic medical records HIV testing prompts, created new testing promotional materials, and held the first VHA HIV Testing Week in the summer of 2010, reported James Halloran, a researcher with the VA's Public Health Strategic Healthcare Group.

Before the law was changed, in 2009 only 2.5 percent of VA outpatients were tested for HIV by agency physicians, and just 9.2 percent of outpatients had ever been screened for HIV. After the law was changed, the number of VA outpatients being tested for HIV more than doubled, and 13.6 percent of outpatients reported having ever been tested.

HIV testing rose in all regions, though not uniformly. The rate of positivity declined, probably because more tests were administered, but remained above 0.1 percent in all regions, Halloran said.

Requiring written informed consent and pre- and post-testing "takes a lot of time," so many health care providers skip screening altogether, said CDC's John Brooks, MD, a conference co-chair. HIV tests should be offered as a routine part of health care and omitted only if the patient declines, he said.

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