A review of the issues and sources used to estimate the annual number of HIV tests performed nationally

Issues: A goal of the National HIV/AIDS Strategy is to reduce HIV incidence through expanded testing in healthcare and non-healthcare settings. Testing is critical to increasing the number of persons with known serostatus. Incomplete knowledge exists regarding the extent of HIV testing in the US. Description: CDC contracted with JSI to estimate the number of HIV tests conducted in the US by funding source (public vs. private) and setting. The advantages and disadvantages of nine approaches were explored including primary (surveying laboratories that conduct HIV testing) and secondary (market research, rapid test manufacturers, national surveys, and federal agency reports) data collection activities. For example, a laboratory survey is expensive and time-intensive; further, it is unknown if laboratories would respond and could provide payer and setting information. Market research data are specific to healthcare settings, and data use policies prevent reprinting data. National survey data are easily accessed, but provide information on number of people tested rather than number of tests. Data on publicly funded tests are available through national organization and federal agency reports. Lessons Learned: It is not currently feasible to precisely estimate the total number of HIV tests conducted in the US. The challenge lies in establishing the number of privately funded tests and rapid tests performed in non-healthcare settings. Recommendations: Specific recommendations are to: identify laboratories that conduct HIV testing, and survey a sample to gauge the feasibility of this option; and add questions to national surveys to obtain more specific data on test type and setting.