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Implementation of routine HIV testing in health care settings : issues for community health centers
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  • Corporate Authors:
    National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (U.S.). Division of HIV/AIDS Prevention. ; National Association for Community Health Centers. ;
  • Description:
    Community health centers (CHCs) are important facilities which implement routine HIV testing consistent with the 2006 recommendations issued by the Centers for Disease Control and Prevention (CDC). These CHCs serve as the primary care medical home and family physician for over 16 million people, in 6,000 sites, located in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. CHCs service patients who comprise some of the nation’s most vulnerable populations—people who, even if insured, remain isolated from traditional forms of medical care because of where they live, who they are, the language they speak, or their higher levels of complex health care needs. Patients who seek care in CHCs are disproportionately low income, uninsured or publicly insured, and members of minority races or ethnicities.

    The National Association of Community Health Centers, Inc. (NACHC), through funding from CDC’s Division of HIV/AIDS Prevention, completed a 1-year pilot initiative in six community health centers (19 delivery sites) to integrate HIV screening into routine primary care visits. The pilot program was launched within months of CDC’s 2006 revised recommendations and has resulted in a model, tools, and resources that health centers can use to rapidly launch routine HIV screening. The model and tools have been tested across the 19 clinical sites and can be applied to any health center or primary care entity during the planning and implementation stages. The pilot project found that integrating HIV screening into primary care visits was feasible and acceptable to patients, staff, and clinic leadership. Over the course of the pilot year, HIV testing was offered to over 17,000 non-pregnant patients (compared with fewer than 1,000 non-pregnant patients the previous year). Sixty-six percent of health centers’ patients accepted testing (range = 55–83%). For 56% of patients, this was their first HIV test.

    On cover: Testing.



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