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Routine HIV Testing in the Community Health Center

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MPCA

Clinical presentation at the 2009 MPCA Annual Conference.

Health & Medicine
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Routine HIV Screening in the Primary Care Setting Michigan Primary Care Association Annual Meeting September 28, 2009 Grand Rapids, MI
Why Are We Doing This? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Awareness of Serostatus Among People with HIV and Estimates of Transmission ~75% Aware of Infection ~ 25% Unaware of Infection ~54% of New Infections ~46% of New Infections People Living with HIV/AIDS New Sexual Infections Each Year Marks G, et al AIDS 2006; 20:1447-1450. Accounting for:
Revised CDC Recommendations Adults and Adolescents - I ,[object Object],[object Object],[object Object]
Revised Recommendations Adults and Adolescents - II ,[object Object],[object Object],[object Object],[object Object]
Revised Recommendations Adults and Adolescents - III ,[object Object],[object Object],[object Object]
Revised Recommendations Adults and Adolescents - IV ,[object Object],[object Object],[object Object]
Approaches to HIV Testing ,[object Object],[object Object],[object Object]
Approaches to HIV Testing ,[object Object],[object Object],[object Object]
What makes Routine Screening a good idea? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Center Routine HIV Screening Model Developed by NACHC ,[object Object],[object Object],[object Object],Pilot States Objective: To develop a model for the integration of HIV testing into routine primary care at Non-Ryan White funded health centers along with a model for post test counseling and referral to specialty care
Guiding Principles ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Redesign Principles ,[object Object],[object Object]
Redesign Principles ,[object Object],[object Object]
Redesign Principles ,[object Object],[object Object],[object Object]
Health Center Patient Care Model with Integrated Rapid HIV Testing Patient signs in. Encounter form printed and, together with ROUTINE SCREENING FLOW SHEET, placed in bin for pick-up by nurse/MA. If blood work necessary, provider writes an order. Patient directed to laboratory for blood draw. Front Desk ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Waiting Room Exam Room Laboratory Check Out Patient takes encounter form and proceeds to check out area for scheduling of next visit.
Health Center HIV Screening Algorithm Rapid HIV Test Negative Reactive Inform patient Give “Negative” handout, if desired Review risks, if appropriate Discuss “window period” No further testing ,[object Object],[object Object],[object Object],[object Object],Negative Positive Western Blot Patient likely negative unless recent risk Review risks & prevention Schedule 3 mo repeat Western Blot ,[object Object],[object Object],[object Object],Repeat Western Blot at 5 day follow-up visit Indeterminate
Post Test Counseling & Referral Rapid HIV Test Reactive Negative Positive Western Blot Indeterminate CHC* Notifies DIS of Reactive result *CHC=Community Health Center DIS may come to CHC to counsel pt regarding results, window period, risk reduction; if not CHC does counseling DIS comes to CHC to counsel pt and Western Blot redrawn ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pilot Results ,[object Object],[object Object],[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object],[object Object],[object Object]
The Initiative is spreading around the country ,[object Object],[object Object],[object Object]
For more Information contact ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Routine HIV Testing in the Community Health Center

  • 1. Routine HIV Screening in the Primary Care Setting Michigan Primary Care Association Annual Meeting September 28, 2009 Grand Rapids, MI
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  • 3. Awareness of Serostatus Among People with HIV and Estimates of Transmission ~75% Aware of Infection ~ 25% Unaware of Infection ~54% of New Infections ~46% of New Infections People Living with HIV/AIDS New Sexual Infections Each Year Marks G, et al AIDS 2006; 20:1447-1450. Accounting for:
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