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APHA Scientific Session and Event Listing

Donna Futterman, MD¹, Paul Meissner, MSPH², Stephen Stafford¹, Michelle Lyle, MPH¹, and Robert Beil, MD³. (1) Adolescent AIDS Program, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, 718-882-0232, mlyle@adolescentaids.org, (2) Department of Family Medicine, Montefiore Medical Center, 3544 Jerome Ave, Bronx, NY 10467, (3) Montefiore Medical Group, Montefiore Medical Center, 305 East 161st Street, Bronx, NY 10451

Issues: Approximately 250,000 Americans are unaware they are HIV+ accounting for two-thirds of new infections annually. Prompt identification of HIV+ individuals can reduce transmission and facilitate early links to medical care. To identify those affected, routine HIV counseling and testing (C&T) is necessary, however the current time-intensive model of HIV C&T is a major obstacle to achieving this.

Description: ACTS is a practical, reality-based way to deliver routine HIV C&T in health care settings. In contrast to conventional 45 minute HIV C&T sessions delivered by counselors, ACTS reduces counseling time to 5-10 minutes while meeting CDC and DOH requirements and can be delivered by doctors, nurses and counselors. The ACTS protocol includes Assessing patients' need for testing, obtaining Consent, Testing and delivering results and providing Support in obtaining warranted treatment and/or preventive services. ACTS implementation involves academic detailing, a training manual, pocket guide, chart stickers and promotional posters and brochures.

Lessons learned: In a two-year randomized trial of 10 community health centers in the Bronx, NY, serving approximately 50,000 eligible patients annually, significant increases in HIV testing rates at ACTS sites compared to control sites using standard C&T were seen (p=0.017). Average control testing rates improved from 8.7% in 2003 to 10.9% in 2005. Meanwhile ACTS sites dramatically increased testing from 10.3% to 24.1%. To achieve such success, numerous administrative barriers were overcome and continuous support was necessary.

Recommendations: ACTS should be utilized by clinicians as an effective method for achieving more routine testing of patients in clinical care settings.

Learning Objectives:

• Describe the benefits and barriers to routine HIV counseling and testing in health care settings.
• Articulate and discuss the use of ACTS rapid HIV counseling and testing in health care settings.
• Describe how ACTS can reduce barriers to HIV counseling and testing for doctors, nurses and counselors and is effective at increasing HIV testing rates in health care settings.

Keywords: HIV/AIDS,

Presenting author's disclosure statement:

Not Answered

Handout (.pdf format, 354.3 kb)