D.C. will quiz doctors' HIV/AIDS knowledge to ensure better screening

By Lena H. Sun
Washington Post Staff Writer
Tuesday, November 16, 2010; 9:00 PM

The District government plans to ask the city's more than 4,000 private doctors how much they know about HIV/AIDS as part of a broad effort to urge them to offer routine screening for a disease that has been diagnosed in more than 3 percent of Washingtonians.

Starting Wednesday, the health department will e-mail the physicians asking them to complete a 15-question online survey. They'll be asked to rank the parts of the city and age groups with the highest prevalence rate and to say whether they are aware of the local and federal recommendations about screening. The survey will run through Dec. 3.

The District's HIV/AIDS prevalence rate is the highest of any city in the nation.

Officials and advocates say local studies and anecdotal evidence point to a gap in understanding among doctors about the severity of the epidemic in Washington.

Many doctors may think that only high-risk groups need regular testing, the officials said. But since 2006, the city's health department has recommended that all residents ages 13 to 84 be screened annually for HIV, the illness that causes AIDS.

"If you're a D.C. resident and you're sexually active, you are in a high-risk network called Washington, D.C.," said John Newsome, a spokesman for the Global Business Coalition on HIV/AIDS, TB and Malaria, a nonprofit group that is working with the District government to increase testing and helped develop the survey questions.

"We suspect there are gaps in doctors' understanding of testing guidelines that have changed considerably, and we really hope to understand where they are so we can address any gaps," Newsome said.

A common misperception among many doctors is that the disease affects mostly young people. But the largest share of new diagnoses are among people in their 40s and 50s, according to District data.

Officials say one of the most effective measures to combat the disease is increasing routine voluntary screening, starting in the doctor's office.

Health department studies conducted in 2008 and 2009 found that 75 percent of those with a recent HIV diagnosis, including heterosexual, gay and bisexual residents, had been to at least one medical provider within the previous 12 months. Experts consider those missed opportunities to catch the disease earlier.

Sometimes, the diagnosis does not take place until a patient goes to the emergency room.

"People come in with sprained ankles or cuts or have rashes - all the normal stuff that brings them to an emergency room - and we run a routine HIV screen, and it turns out a number are infected with HIV," said Jeremy Brown, director of emergency department HIV screening at George Washington University Hospital.

The rapid bedside test takes 20 minutes, involves swabbing the gums and is extremely reliable, he said.

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