By Natalie Cramer, Director, Prevention, NASTAD
Last fall, the National Alliance of State and Territorial AIDS Directors (NASTAD) released the first report of our 2012-2013 National HIV Prevention Inventory on health department HIV testing programs. This report is a follow-up to previous NASTAD reports on rapid HIV testing and testing in health care settings and contributes to our continuing efforts to monitor health department supported HIV testing programs. Findings in this report contribute to the development and prioritization of our technical assistance activities and guide education and advocacy efforts.
In 2009, NASTAD in conjunction with the Kaiser Family Foundation (KFF) released the first National HIV Prevention Inventory: The State of HIV Prevention Across the U.S. (NHPI). This seminal report provided the first, comprehensive inventory of HIV prevention efforts at the state and local levels. The document provided a baseline picture of how HIV prevention is delivered across the county in an effort to provide policymakers, public health officials, community organizations and others with more in depth understand of HIV prevention and the role played by health departments in its delivery.
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The past several years have seen several critical developments in the field of HIV prevention that have compelled health departments to make significant steps to refocus their HIV prevention programming. These developments include the:
- Release of the National HIV/AIDS Strategy (NHAS)
- Release Centers of Disease Control and Prevention’s (CDC) funding opportunity announcement (FOA) PS12-1201:Comprehensive HIV Prevention for Health Departments
- Introduction of CDC’s “high impact prevention” (HIP)
- Passage of the Affordable Care Act (ACA)
- Scientific breakthroughs in the area of treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP)
- USPSTF Grade A recommendation for the HIV testing
The findings from the 2012 NHPI Testing Report demonstrate that health departments continue to play a significant and increasing role in HIV testing. Key findings include:
- 12% increase in the volume of health department HIV tests (targeted and routine) between 2009 and 2011, leading to more than three million tests being conducted each year by health department HIV programs
- Nearly 70% of health departments reported that HIV testing in clinical settings will increase “somewhat” or “a lot” over the next year, further expanding access to HIV testing resources
- Health departments have been successful at integrating sexually transmitted disease (STD) and hepatitis C virus (HCV) testing with HIV testing in a range of settings including STD clinics, community-based organizations (CBOs), community health centers (CHCs), family planning clinics and partner services activities
- Financing HIV testing through third-party reimbursement remains a significant challenge for health departments and their providers funded for HIV testing
The NHPI is a tool to support policy makers, public health officials, community organizations and other stakeholders in better understanding the current state of U.S. HIV prevention. The updated NHPI will be produced as a series of modules examining various aspects of health department HIV prevention programs in the U.S.
NASTAD continues to provide technical assistance opportunities designed to support health departments in strengthening their HIV testing programs and response to PS12-1201. One such opportunity was a webinar titled “Using Advances in HIV Testing Technology and Testing Strategies Strengthen Health Department HIV Testing and Linkage Programs.” During webinar, health department leaders described their HIV testing programs, with an emphasis on adoption of new and emerging HIV test technologies and strategies. Challenges and lessons learned were also shared. NASTAD continues to develop webinars to assist health departments with the implementation of PS12-1201 and to support technical assistance to health departments on all components of their HIV prevention programming including HIV testing.
What suggestions do you have for technical assistance to support HIV testing programs? Let us know by leaving us comment below.