FEATURE ARTICLE
Expanding HIV Testing for Veterans
Kansas AETC Trains

HIV Testing (Clinician Resources) AETC National Resource Center | Revised Guidelines for Counseling, Testing, and Referral | AETC/CDC Testing Initiative Poster Session

HIV testing is rare in the Nation’s veterans care system—surprising given that the Department of Veterans Affairs (VA) is the biggest single provider of HIV/AIDS care in the U.S.  Only around 10 percent of all veterans in the VA system have ever received an HIV test.  That is changing as the VA ramps up HIV testing in select pilot sites as part of its operational plan to implement the 2010 National HIV/AIDS Strategy and its call to engage more infected individuals into care. HHS testing recommendations released in 2006 endorsed routine testing in health care settings. The VA subsequently revised its policies on HIV testing in 2009, paving the way for further expansion of routine HIV testing in VA settings.

Ryan White Helps Train VA Staff

The Ryan White HIV/AIDS Program is helping the VA put testing in place in several VA pilot sites that were funded in 2010 to implement routine HIV testing under a VA project called the PACT HIV Testing Grant Initiative. The site, the Robert J. Dole VA Medical Center in Wichita, Kansas, serves 59 Kansas counties, through 6 Community-Based Outreach Clinics in rural Kansas, and 81-bed facility in Wichita.  The Dole Center is receiving training in HIV testing from the Kansas branch of the Mountain Plains AIDS Education and Training Center (AETC), part of the national network of AETCs that conduct clinician training for the Ryan White HIV/AIDS Program.  AETC training covers testing methods as well as linking people to care and increasing awareness of HIV screening across the VA health care community.

Several of the other 4 pilot sites are also collaborating with their regional AETCS on training. For example, the Fort Harrison site in Montana received training from the Montana state health department and Northwest AETC, providing staff with access to training either in person or online for CEU credit using the AETC’s HIV Web Study site.

AETC s are well-equipped to provide training on HIV testing. Since 2007, AETCs across the country have been training clinicians in HIV testing under a funding partnership with the Centers for Disease Control and Prevention (CDC) as part of a national effort to expand HIV testing as a routine screening activity.  The AETC/CDC project conducted over 3,100 trainings and trained 48,800 providers from 2007-2010.  Over 500 sites have thus far implemented routine HIV testing.

The Results So Far

In 2010-2011, the Kansas AETC trained over 165 VA clinic and hospital staff in HIV testing techniques.  As a result, testing is way up.

• From April 2009 to April 2010, prior to start-up, the Dole VA center conducted 319 tests, identifying 8 HIV-infected patients.
• From April 2010 to February 2011, Dole VA Center delivered 1,083 tests and found 16 HIV-infected patients—double the number from the last year.

One of the features of the Kansas AETC training that could be replicated in other areas is a series of clinician support tools that were shared with each VA provider (see sidebar). These tools have since been uploaded to the internal VA computer system so all departments and providers can access the HIV resources and tools "on demand."

The VA hopes to package its HIV testing pilot sites into successful models for adoption nationwide. Learn more about HIV/AIDS and Veterans and how Ryan White and VA programs interface in serving veterans.