204688 Need to Improve Routine HIV Testing of U.S. Veterans: Results of an Internet Survey

Tuesday, November 10, 2009: 3:10 PM

Ronald Valdiserri, MD, MPH , Public Health Strategic Health Care Group (13B), U.S. Department of Veterans Affairs, Washington, DC
Kim Nazi, MA , Stratton VA Medical Center, Veterans and Consumers Health Information Office, Albany, NY
Keith McInnes, ScD, MS , Bedford VA Medical Center, Center for Health Quality Outcomes and Economic Research, Bedford, MA
David Ross, MD, PhD , Public Health Strategic Health Care Group (13B), U.S. Department of Veterans Affairs, Washington, DC
Linda Kinsinger, MD, MPH , National Center for Health Promotion and Disease Prevention, Durham, NC
Background: Late diagnosis of HIV infection contributes to poor medical outcomes and helps sustain continued transmission of virus. Published evidence suggests that despite current public health recommendations, patients receiving care in the Veterans Health Administration (VA) system are not being routinely tested for HIV infection. Using a sample of computer-literate veterans, we conducted a survey of recent testing experiences.

Methods: My HealtheVet (MHV) is a secure website allowing registered veterans to access limited personal VA health information. Using the American Customer Satisfaction Index (ACSI) Survey, an electronic questionnaire on “Health Screening” was conducted in late Fall 2008. A random sample (4%) of MHV users were surveyed; approximately 17% completed the survey (12,712).

Results: Only 9% of the respondents indicated that they have been offered a test for HIV in the last 12 months compared to 83% who had been offered cholesterol screening and 19% who had been offered testing for Hepatitis C virus (HCV). Of those who had been offered HIV testing, 91% indicated that they'd had the test performed. Of note, the percentage of respondents who indicated that they would “very likely” accept a test, if offered, was similar for HIV (73%), HCV (79%) and cholesterol (75%).

Conclusions: Although these results cannot be generalized to all veterans in care, they support growing evidence that routine testing for HIV is not taking place. Efforts targeted at both providers and patients must be undertaken in order to promote routine testing of HIV in support of the goal of early HIV diagnosis.

Learning Objectives:
Describe the self-reported frequency of the offer of HIV testing to U.S. veterans in care compared to other, select, recommended clinical preventive services.

Keywords: HIV/AIDS, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published a number of articles in the public health literature on a broad variety of HIV prevention topics, including the importance of timely diagnosis of HIV infection. I have also authored three books on the subject of HIV/AIDS.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Critical Research in HIV Testing
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