Ryan White and HIV Testing Day

June 20, 2019

TargetHIV

About 15% of the people in the U.S. who have HIV do not know they are infected. That's about 162,000 individuals (or 1 out of 7 of the nation's 1.1 million people living with HIV). According to CDC, 40% of new HIV infections are transmitted by people who are untested/undiagnosed.

However, significant progress has been made in recent years as a greater proportion of HIV-infected individuals know their serostatus and are in care, which has the added value of serving as a highly effective prevention strategy: individuals whose virus is fully suppressed are highly unlikely to transmit HIV to others. Doubling down on that progress is one of the goals of Ending the HIV Epidemic: A Plan for America.

Ryan White HIV Testing Resources

A wide range of HIV testing and care engagement interventions have been developed over the decades by HRSA's Ryan White HIV/AIDS Program (RWHAP). Below is a summary of select efforts. See our HIV Testing and Diagnosis topic page for more.

Clinic-Focused HIV Testing

Many of the RWHAP's clinic-based HIV testing efforts have been developed under the program's AIDS Education and Training Centers (AETC) Program, the clinician-training arm of the RWHAP. Highlights include:

Resources for Clinicians. The AETC National Coordinating Resource Center produced the Immediate ART: Quick Guide for Clinicians in 2019 and offers much more on their topic page on the HIV Continuum of Care's Step 2: Identifying Cases through HIV Testing & Diagnosis. Regional and local AETCs also provide training on testing-related topics for clinicians.

National HIV Curriculum. This online training tool's section on Screening and Diagnosis covers HIV testing in depth, including testing recommendations, new diagnostic tests and how to address the complexities of test interpretation. Section topics include: Epidemiology of HIV: HIV Screening Recommendations; HIV Diagnostic Testing; Acute and Recent HIV Infection; and Linkage to HIV Care.
Clinician Consultation Center. The AETC CCC provides clinician-to-clinician expert advice on a broad range of HIV topics, including testing, care management, PrEP, PEP and more.

Ryan White HIV Testing Interventions

Highlighted below are several HRSA-funded evidence-based interventions that focus on HIV testing and engaging people in care, prepared under IHIP: Integrating HIV Innovative Practices.

Case Study - Social Networks Testing is a project that recruits HIV-positive or high-risk HIV-negative individuals to be the lead in engaging high risk persons in HIV testing. This approach is potentially more effective than traditional testing and outreach methods. The case study describes the model (e.g., staffing needs) as well as replication tips (e.g., appoint a project leader and champion, develop protocols, pick a limited number of agencies to work with to implement the effort).

Image credit:
Social Networks Testing, Wisconsin Department of Health Services

Case Study - Assess, Test, Link- Achieve Success (ATLAS) Program is an 8-step intervention (summarized below) that starts with HIV testing followed to steps to link incarcerated individuals into the community upon release. One focus is to integrate jail-based case managers into the community HIV case management system. This HRSA-funded IHIP resource describes the model (e.g., staffing needs) and presents replication tips (e.g., offer opt-out HIV testing is not prevented by jail policies or space limitations in the jail).