D.C. Wants HIV Testing for All Residents 14 to 84

Brandon Armani, right, with Unity Health Care works at a mobile HIV testing center last year. The District has the highest national rate of new AIDS cases, 179.2 per 100,000 people.
Brandon Armani, right, with Unity Health Care works at a mobile HIV testing center last year. The District has the highest national rate of new AIDS cases, 179.2 per 100,000 people. (By Michael Robinson-chavez -- The Washington Post)
By Susan Levine
Washington Post Staff Writer
Saturday, June 24, 2006

The District will launch a campaign next week urging every resident between the ages of 14 and 84 to be tested for HIV, an ambitious undertaking that public health officials say is critical to reversing rates of infection that are among the worst in the country.

The citywide campaign, which appears to be unprecedented in its breadth, will target 400,000 men, women and teenagers and encourage them to learn their HIV status through an oral swab that delivers results in 20 minutes.

Organizers want the rapid test to become as common a part of any medical exam as blood-pressure monitoring or a cholesterol check. The hope is that the results, especially if positive, would influence a person's sexual behavior and motivate him or her to seek treatment.

The D.C. Health Department has 80,000 tests on hand for free distribution to hospital emergency rooms, private physicians' offices, community health programs and public settings such as the city's detoxification center and substance abuse and STD clinics. Officials aim to exhaust that supply before the end of the year, which would mean reaching a fifth of their key population in the next six months.

"If we are serious about addressing this epidemic in our community, then screening for HIV has to become routine," said Marsha Martin, who heads the city's Administration for HIV Policy and Programs. "Because we'll miss too many people otherwise."

That approach dovetails with proposed guidelines from the federal Centers for Disease Control and Prevention. The CDC is considering a recommendation "strongly encouraging" doctors to offer HIV tests as a matter of course to patients ages 13 to 64.

City officials do not know how many people have HIV, the virus that causes AIDS, because local data are incomplete. But AIDS afflicts one in 50 District residents, or almost 10,000 people. The nation's capital has the highest rate of new AIDS cases in the country, at 179.2 per 100,000 people, with African Americans disproportionately affected.

Nationally, the CDC estimates, 25 percent of the more than 1 million Americans living with HIV are unaware they are infected.

"We have to start making it part of the public consciousness, that HIV is of and among us," Martin said.

In a review this past spring of the District's HIV/AIDS programs, the D.C. Appleseed Center for Law and Justice recommended a citywide strategy for standard HIV screening. The public service organization has been critical of local officials' response to the epidemic, which it considers one of the most dire health problems facing the District.

Appleseed Executive Director Walter Smith applauded the campaign yesterday. "I don't think you'll find routine citywide testing anywhere in the country," he said. "It's an important and bold step forward, and we welcome it."

But, he said, "It's crucial that along with testing goes appropriate pre- and post-testing counseling."


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