Few Veterans at US Government Care Facilities Receive Testing for HIV: Presented at IDSA

By Ed Susman

VANCOUVER -- October 26, 2010 -- The percentage of patients in the US government-run Veterans Affairs medical facilities who have been tested for HIV infection is less than 10%, despite government recommendations that patients receive routine HIV testing, researchers stated here at the 48th Annual Meeting of the Infectious Diseases Society of America (IDSA).

"We don't know why these testing levels are so low, but they are even low in areas where HIV has a large prevalence," said Meredith Welch, MD, Veterans Affairs Medical Center/George Washington University Medical Center, Washington, DC.

Dr. Welch noted that 5.7 million outpatients were seen in the Veterans Affairs system in 2009. In a detailed survey of that system, however, it appeared that, as of 2009, just 9.2% of these outpatients had been tested ever before for HIV, with 2.5% of these patients tested within that year.

In the District of Columbia, where HIV infection prevalence is just over 1,402/100,000 persons, about 21.6% of outpatients have ever been tested for HIV, Dr. Welch said here at her poster presentation on October 23.

In New York, where the prevalence of HIV is just over 777/100,000 persons, about 11.8% of people in the Veterans Affairs health system have ever been tested for HIV.

In places where prevalence of HIV is low, such as Utah with a prevalence of just over 105/100,000 persons, just 2.7% of outpatients in the Veterans Affairs facilities there have ever been tested for HIV.

"The Centers for Disease Control and Prevention has recommended HIV testing for all persons aged 13 to 64 or pregnant women since 2006," Dr. Welch said. "The federal law requiring written informed consent for HIV testing with pre- and post-test counselling within Veterans Affairs was repealed in 2008."

Despite removal of such barriers, there still appears to be a slow uptake of testing in the Veterans Affairs system. Dr. Welch suggested that her study could act as a baseline for future studies that will determine how well the Veterans Affairs health system is performing in testing for HIV.

"There may still be some stigma involved with HIV that prevents physicians from asking patients to undergo an HIV test," she speculated.

[Presentation title: Initial Assessment of HIV Testing Among Outpatient Veterans Compared With US Rates of HIV/AIDS. Abstract 1063]

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