BACKGROUND

Across the nation, differences in policies related to consent and counseling for HIV testing present various challenges to implementing testing programs. While policies in California, Texas, and  Washington, DC, for example, may facilitate routine HIV testing by allowing consent for the test to be a part of the general consent procedure, in some states where separate consent or pre-test counseling for HIV are still required, scale-up programs must accommodate current state policies. 

Funding for efforts to scale-up testing in different municipalities come from a variety of sources.  In 2007, CDC provided funding for their Expanded Testing Initiative to increase testing for populations disproportionately affected by HIV, primarily African Americans.  Testing programs were funded in 25 jurisdictions across the U.S. that represent 95% of AIDS cases among African Americans in 2005.  Despite efforts to increase testing in these jurisdictions, a 2009 NASTAD report highlights key challenges still facing these programs including difficulties in reporting testing to health departments, staffing and contracting issues, program capacity, and sustainability

CDC surveillance data indicate that the majority of AIDS cases in the U.S. are concentrated in a small number of cities across the country.  AIDS cases in only 34 metropolitan statistical areas represent over 80% of cases in the nation.

In order to scale-up testing programs, considerations about support will need to be made by individual municipalities.  Plans could range from full support for HIV testing by clinicians that include health department provided test kits, support for costs of testing (both rapid and conventional testing), and support for testing staff to partial support that includes (for example) only clinician training or awareness campaigns

OBJECTIVES:

1. To bring together the various stakeholders (city and state health departments, researchers, community and advocacy representatives, and federal agencies that are supporting routine testing initiatives.)
2. To review what works and what does not work in municipal HIV testing scale-up and review lessons learned.
3. To discuss the different models needed for scale-up of routine HIV testing under varying state and local testing regulations.
4. To discuss models for sustaining municipal-wide testing programs with limited resources and competing program needs.
5. To assess the impact of successful scale-up programs on the availability of treatment and other services (including mental health, substance abuse, housing or other programs)

STATUS:

The roundtable was held May 18, 2010 at the Hyatt Regency Crystal City in Arlington, VA.

PLANNING COMMITTEE MEMBERS: