Collaboration between medical and non-medical HIV testing settings under revised CDC guidance

Issues In 2006, the CDC released revised recommendations for HIV testing in health-care settings. These guidelines, which call for streamlined and routine testing, are separate and distinct from other recommendations that relate to non-medical HIV testing settings. This can be challenging for jurisdictions such as San Francisco, where HIV testing programs that are overseen by the Department of Public Health consist of both medical and non-medical sites. Description Testing sites in the San Francisco HIV Counseling, Testing, and Linkage (CTL) Network range from county jails to STD clinics to community organizations testing in mobile vans and at club parties. Incorporating the revised CDC guidance for medical settings while maintaining consistency with the policies and procedures of non-medical settings has required a great deal of collaboration and problem solving between each of these entities. Lessons Learned Communication between providers in medical settings and policymakers at the Department of Public Health which oversees them is essential to the success of this collaboration. Compromises that work for everyone must be reached. For example, testing can be offered to all patients rather than screening for risk, but obtaining written informed consent is still a requirement for community clinics part of the CTL Network. Recommendations Cities or counties that have a system where the Department of Public Health contracts with local entities to provide HIV testing would benefit from a discussion about how to jointly meet the needs of medical and non-medical settings and maintain consistently of protocols for testing across a network.