June 23, 2016 TARGET Center
The proportion of HIV-infected individuals who know their status has improved in recent years, demonstrating progress toward objectives set forth in the National HIV/AIDS Strategy and an earlier Ryan White video, Test and Treat ).
HRSA/HAB Policy Guidance on PrEP
See the June 22 2016 HRSA/HAB Dear Colleague letter on PrEP . The letter reiterates that Ryan White funds cannot be used for PrEP medications or medical services related to PrEP such as physican visits or lab tests related to PrEP. However, HRSA/HAB states that Ryan White fund recipients and providers can provide services like risk reduction counseling and targeted testing that are part of a comprehensive PrEP program.
Despite progress, gaps remain. According to CDC, approximately 12.8% of infected individuals remain unaware of their status and thus are not benefiting from antiretroviral treatment. Many of the 50,000 new HIV/AIDS infections occurring each year are transmitted by individuals who do not know they are infected.
HIV/AIDS Counseling and Testing Resources
Care agencies, including HIV/AIDS programs, have policy flexibility and technical resources to help them expand HIV testing in order to identify infected individuals and engage them in care. The need to do
- Health Care Reform and HIV Testing. In April 2013, the U.S. Preventive Services Task Force (USPSTF) issued recommendations that assigned an “A” rating to routine HIV testing for all adolescents and adults ages 15 through 65. The new rating means that routine HIV screening is now defined as one of the preventive services under the Essential Health Benefits (EHB) package that must be included in all new group and individual plans under the Affordable Care Act (ACA).
- HRSA/HAB Policy Guidance. Ryan White agencies can turn to guidance from HRSA on use of Ryan White funds for HIV counseling of testing. Such guidance comes in the form of Funding Opportunity Announcements (FOAs) for grantees along with Ryan White policies and letters. They include Use of Ryan White HIV/AIDS Program Funds for HIV Diagnostics and Laboratory Tests , 07-02 and a 2/25/13 HRSA/CDC letter clarifying testing and the timely linkage to care for individuals who have received an initial positive test result.
HIV Testing Technical Resources
A good starting place to learn about HIV couseling and testing is CDC's HIV Testing to guide them in carrying out testing in the care setting. See also a series of sessions on HIV testing, held at the June 2015 National Summit on HCV/HIV (search the page for "test").
Highlights for the HIV counseling/testing collection include:
- Testing and Assessment in the HRSA/HAB Guide for HIV/AIDS Clinical Care . Chapters cover testing in the context of, for example, initial intake and evaluation and rapid testing.
- Testing Resources for Clinicians . The AETC National Resource Center has a topic page with a collection of clinician training materials (e.g., curricula, fact sheets, patient education materials). See also the AETC HIV Testing Collaborative .
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