Integrated HIV, STD, and HCV Testing Practices Among a Sample of HIV Testing Providers in New York State

Background:  CDC’s Program Collaboration and Service Integration (PCSI) guidance, a 2010 realignment of HIV, STD, and HCV programs under a single leadership structure within the state health department, and recent expansion of AIDS Institute funding initiatives to include STD and hepatitis with HIV/AIDS services have contributed to a paradigm shift supporting integration of services at the client level.

Objectives:  To assess current integrated HIV, STD, and HCV testing practices among HIV testing providers, and identify technical assistance needed to overcome perceived barriers to offering integrated services at the client level.

Methods:  NYS agencies that provide HIV testing were invited to participate in the survey (N=101).

Results:  Forty-one agencies responded to the survey (recruitment ongoing). Of the twenty-three that provide HIV, STD, and HCV testing, 26% offer all three tests to clients at the same time and 43% offer HIV and STD testing at the same time. Only 56% routinely conduct HCV testing (including through referral); while 93% routinely conduct STD screening. Barriers to providing STD and/or HCV testing include cost, patient motivation, and staffing concerns. Respondents were interested in technical assistance including educational materials, sample screening protocols, and rapid HCV testing.

Conclusions:  Agencies were at different stages of providing integrated testing at the client level and were using a range of models of service delivery. Most agencies in our sample have the capacity to test their clients for STDs; HCV testing is more of a challenge. Patient and provider education regarding the rationale for integrated testing and addressing the cost of HCV testing are needed. Other technical assistance needs to increase PCSI effectiveness were identified.

Implications for Programs, Policy, and Research:  It is important to monitor progress towards service integration, and provide technical assistance, if integrated HIV, STD and HCV testing is to succeed as a model of care.