As the United States marks the 30-year anniversary of the discovery of the HIV virus and AIDS, Allegheny General Hospital—where patients from northern Washington County are routinely taken for treatment in emergencies—has initiated a routine HIV screening program, making HIV testing available to nearly every patient seen in its Emergency Department.
Allegheny General has partnered with the Pennsylvania Expanded HIV Testing Initiative, also known as PEHTI, in its mission to see that HIV testing becomes a standard part of health care, just like checking blood pressure.
“This is a nationwide effort that stems from the fact that although we are 30 years into the HIV/AIDS epidemic, incidence in the U.S. (60,000 new cases per year) has not decreased in 10 years,” said Mobola Kukoyi, project coordinator for PEHTI.
“It is estimated that more than 1 million Americans are infected with HIV and one in every five are not aware of their infection. Thus, (the Centers for Disease Control and Prevention) has proposed a different way of approaching HIV testing.”
By funding programs like PEHTI across the nation, the CDC hopes to identify new cases of HIV to help prevent the spread of the virus. It’s also an effort that can decrease healthcare costs. With 40 percent of new HIV diagnoses progressing to full-blown AIDS within one year, early detection enables health care providers to start treatment sooner, when it is likely to be most effective and before patients become so sick that they require more costly interventions.
HIV information and screening was offered by the Emergency Department at AGH beginning in December. Hospital staff are refining the processes for the screenings with the goal of offering tests to every emergency department patient between the ages of 13 and 64, in compliance with guidelines issued by the CDC and, more recently, the Pennsylvania Department of Health.
The screening is a non-invasive swab of the upper and lower gums and patients are given a negative or “reactive” test result before they leave, according to Laura McNeil, a nurse educator in the emergency department. Reactive tests don’t necessarily indicate that a patient is positive for HIV, but that follow-up testing is needed.
McNeil said any patients with a reactive result to the rapid HIV screening will receive a blood test and be referred to Allegheny General’s Positive Health Clinic to receive their results and additional information and counseling.
Since 2002, West Penn Allegheny Health System has offered early HIV intervention and treatment in the Positive Health Clinic. Funded by a federal grant under the Ryan White CARE Act of 1990, Positive Health provides services to meet the complex needs of people living with HIV and their loved ones, regardless of an individual’s ability to pay.
The Pennsylvania Department of Health’s epidemiological profiles identified Allegheny County as one of the highest-risk areas for HIV/AIDS in Pennsylvania, second only to Philadelphia County. Making HIV testing part of standard everyday procedures is critical to decreasing the number of cases that go undiagnosed.
“Over the years we’ve had so many people come through the Emergency Department and be diagnosed with late-stage AIDS,” said Mary Gallagher, Positive Health Clinic manager. “In many cases, the people were involved in medical care, but nobody ever tested them for HIV.”
Patients who decline to be tested will still receive information on HIV, the importance of screening and where tests are available.
“Even if we don’t have an impact that day, the patient walks away with more information than they had,” Gallagher said. “We want to drive home the message that if you’re sexually active, you’ve got to get tested—period.”