Routine HIV Screening in Primary Care

Background:  In 2010, the state of Georgia had an estimated HIV prevalence of 187.1 diagnosed HIV infections per 100,000 people. Three of the four counties in the Metro Atlanta area had rates vastly exceeding the state’s rate. The CDC estimates that 21% of the nation’s estimated 679,590 people with HIV are still unaware of their status. The Centers for Disease Control and Prevention issued Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings to include routine testing of individuals ages 13-64 to determine HIV status.

Methods:  Beginning June 1, 2012 and ending September 30, 2013, Opt-out serum HIV screens were offered to all individuals age 13-64 years, with known or unknown HIV status, presenting for a visit in a group of primary care clinics located in the Metro Atlanta area.

Results:   During the fifteen months sited, 7718 serum HIV screens were performed with additional testing to confirm positive screens. Forty-five of the individuals tested ( 0.58%) were found to be HIV positive. (95%) of the individuals found positive were African-American, (57%) were male and (27%) were between the ages of 23-30 years.  

Conclusions: Of the individuals (45) testing HIV positive, thirty (66%) did not know they were HIV positive and fifteen (34%) later reported they were previously determined positive for HIV prior to the routine HIV screen performed. All forty-five (100%) of these individuals, regardless of newly or previously determined HIV positive status, were linked to and completed at least one visit with a medical care provider and were given treatment related to their positive HIV status. It was also determined that 66% of the patients newly diagnosed were established patients within the primary care clinics and had not been offered HIV screening until routine HIV screening was established.