Increasing testing volume and finding new infections with a routine HIV screening program in New Orleans

Issues:  As of September 2013, 7,219 persons are currently living with HIV/AIDS in the New Orleans metropolitan service area.  New Orleans ranks 2nd nationally for HIV infection and 4th nationally for AIDS prevalence (up from 9th place in 2009)[i]

Description:  Since March 2013 all patients presenting for care to the Interim LSU Hospital ED or Urgent Care Center (UCC) in New Orleans are tested for HIV using the CDC recommended opt out method with the goal of testing 42,000 individuals.  Formerly, LSU used a dedicated tester model but now testing is integrated into routine medical care.  A retrospective study conducted by program director, Dr. Lisa Moreno, examined the limitations of point of care tests in the ED.  This study laid the groundwork for LSU’s utilization of 4thgeneration testing technology to capture recent and acute infections in both the ED and UCC.  The dedicated testers previously used in the program were repurposed as phlebotomists and assigned linkage to care duties.  These clinical navigators establish linkage to care for positive persons to four neighborhood clinics.  After hours a public health advocate will engage the patient and maintain close contact until the patient is effectively linked to care.  This intervention normalizes attitudes about testing, identifies more acute infections, and decreases the percentage of patients who have AIDS at the time of diagnosis.

Lessons Learned:    From inception to November 2013, we have tested 11,875 persons.  88 persons were newly diagnosed and 5 acute infections have been identified.

Recommendations:   In order  to increase our testing volume,  in March 2014 we will launch our HIV public education awareness campaign with radio, TV, and print ads informing the public about the importance of knowing your status and getting tested.

[i] Centers for Disease Control and Prevention.  HIV Surveillance Report, 2011; vol 23.  Published February 2013.