man_thinking_web.jpgA three-year $111 million program to expand access to HIV testing in 25 of the areas most affected by the virus that causes AIDS provided nearly 2.8 million tests and diagnosed 18,432 people who had been unaware they were infected, the Centers for Disease Control and Prevention announced.

The initiative initially targeted African Americans and was particularly successful in that population, the CDC said.

The announcement coincided with National HIV Testing Day, observed on June 27.  While data show that more Americans than ever have been tested for HIV at least once, the majority still has never received a test. The CDC estimates that one in five or about 240,000 of the nearly 1.2 million people living with HIV do not know they are infected. 

During the three-year period, African Americans accounted for 60 percent of tests performed (1.4 million) and 70 percent of new HIV diagnoses (11,638), and  were 1.6 times more likely to test positive for HIV than whites (0.8 percent) or Hispanics (0.5), reflecting long-standing disparities in the HIV epidemic, the CDC said. 

Like other racial and ethnic groups, as many as one-third of African Americans with HIV are diagnosed late in the course of their infection, when treatment is less effective and after many opportunities to prevent further spread of the virus have been missed, the agency said.

CDC data show that while African Americans represent 14 percent of the U.S. population, they account for nearly half of annual new HIV infections.  Research shows that a range of social and environmental factors, including lack of access to health care, poverty, higher rates of STDs, stigma and homophobia, place communities of color, especially African Americans, at greater risk for HIV, the CDC said.

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“Ensuring that all Americans know their HIV status is critical to reducing new infections and putting an end to the epidemic,” said Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

“These results demonstrate that the nation is making steady progress toward that vision.  But more than half of U.S. adults aged 18-64 still have never been tested for HIV, and our work is far from over,” Fenton said.

The CDC launched the Expanded Testing Initiative to support its 2006 “Revised Recommendations for HIV Testing of Adults, Adolescents and Pregnant Women in Health Care Settings.”  The recommendations, which call for HIV testing to become a routine part of healthcare for all American adults and adolescents, are designed to remove key barriers to testing in healthcare facilities.

Between October 2007 and September 2010, the CDC provided funding to state and local health departments to support routine HIV testing, primarily in health care settings, such as emergency rooms, sexually transmitted disease clinics and doctors’ offices, as well as in select community venues.  The effort focused primarily on reaching African Americans, who are more severely affected by HIV than any other race or ethnicity in the United States. 

Based on preliminary indications of the program’s success, in October 2010 the CDC expanded the focus and funding of the initiative. The agency now provides funding to 30 areas – up from 25 – to reach several populations heavily affected by HIV, including African Americans, gay and bisexual men, Latinos and injection drug users. 

In addition to focusing the initiative on African-Americans, the CDC also took steps to ensure that resources were directed to reach other populations at the highest risk for HIV.  Health departments in the 25 participating jurisdictions were asked to utilize local epidemiological data to identify and prioritize specific venues serving hard-hit communities.

“These results are exciting and encouraging,” said Dr. Jonathan Mermin, director of the CDC's Division of HIV and AIDS Prevention. “They remind us that high-impact prevention works.  With collaboration and focus on those who are hardest hit by this disease, we are making great strides in the fight against HIV.”