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CDC Reports on Expanded HIV Testing Initiative


Monday June 27 is National HIV Testing Day. The purpose of the day is to promote HIV testing, improve self-awareness of one’s HIV status, and enable earlier diagnosis of HIV infection. Too many continue to be unaware of their HIV status which delays treatment. Approximately 20% of the estimated 1.2 million persons living with human immunodeficiency virus (HIV) infection in the United States at the end of 2008 were not aware of their infection.

Historically, HIV testing often has been targeted based on individual risk factors. This is changing. In 2006, CDC recommended screening all patients aged 13--64 years for HIV infection in health-care settings that have a prevalence of undiagnosed HIV infection of ≥0.1%. Individuals at risk should be retested at least annually.

In October 2007, the Centers for Disease Control and Prevention (CDC) launched their Expanded HIV Testing Initiative (ETI). Over the 3-year ETI program period (2007-2010), the CDC provided an additional $111 million to health departments in 25 U.S. jurisdictions that had reported 140 or more AIDS diagnoses among blacks in 2005. The ETI funds were used to facilitate HIV screening and increase diagnoses of HIV infections and linkage to care.

Semiannually, health departments used progress report forms developed by CDC to report ETI-specific activities and outcomes, including the number of HIV tests and the venues in which tests were conducted, basic demographic information about test recipients, the number of confirmed new and previously diagnosed HIV infections identified, and the proportions of persons with new HIV diagnoses successfully linked to medical care and referred to partner services.

During the 3-year course of ETI, the yield of new HIV diagnoses exceeded CDC's recommended screening threshold (0.1% undiagnosed prevalence) in every clinical venue in which expanded screening was implemented.

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A total of 2,786,739 HIV tests were conducted, of which 29,503 (1.1%) were positive for HIV infection. Among persons who were HIV-infected, 18,432 (62%) were unaware of their infection.

Men accounted for 55% of all tests and 72% of new HIV diagnoses; their test positivity rate was more than twice that among women (0.9% versus 0.4%)

Non-Hispanic blacks, compared with non-Hispanic whites and Hispanics, accounted for approximately three times as many tests (60% versus 18% and 16% respectively) and approximately five times as many new HIV diagnoses (70% versus 14% and 12%, respectively). Similarly, the test positivity rate among blacks (0.8%) was 1.6 times that among whites (0.5%) and Hispanics (0.5%).

Those tested in clinical settings were more likely to receive their test results (93% versus 84%) and be linked to care (78% versus 63%).

Awareness of one’s HIV status is important as is continued safe sex practices.

To protect yourself from getting HIV

  1. Don't have sex at all (anal, vaginal, and oral sex).
  2. Only have sex (anal, vaginal, or oral) if you are in a mutually monogamous relationship and you have both tested negative for HIV.
  3. Use a condom every time you have anal, vaginal, or oral sex.
  4. Reduce your number of sex partners; this will reduce your risk of getting HIV as well as other STDs.
  5. Encourage all sexual partners to get tested for HIV and make sure they tell you the results.
  6. Locate an HIV and STD testing site near you or from your mobile phone, text your zip code to KNOWIT (566948). You can also call 1-800-CDC-INFO for assistance in locating a testing site.
  7. If you are a man who has sex with other men or if you engage in anal sex, get vaccinated against hepatitis A and B viruses.

CDC MMWR: Results of the Expanded HIV Testing Initiative --- 25 Jurisdictions, United States, 2007—2010; June 24, 2011 / 60(24);805-810