Dramatic improvements have occurred in the care of HIV positive patients since this disease emerged thirty years ago. Today treatment of what was a devastating and fatal disease can be as simple as a single pill a day. Patients can live productive lives without focusing excessively on their HIV disease.
Yet despite tremendous gains in the medical care of HIV positive individuals, response to the social issues that are related to HIV infection has not been as impressive. HIV infection, stabilized at an estimated 55,000 new cases per year, has become increasingly concentrated among the poor, particularly African-Americans, as well as among men who have sex with men (MSM). Consequently there are large racial disparities in infection rates, timely diagnosis and treatment outcomes. The significance of increased rates of infection and delayed diagnosis is considerable; HIV positive persons who are aware of their status usually decrease risky sexual behaviors and thus reduce the risk of transmitting infection to others. Additionally, delayed diagnosis contributes to decreased survival rates among HIV infected Blacks compared to their Hispanic and White counterparts.
Consequently the importance of routine HIV testing for adolescents and adults advocated by Test Miami, the Miami-Dade County Health Department’s initiative to increase HIV testing in medical settings, is evident. Routine screening in medical facilities is a cost effective health care intervention in communities such as ours where the prevalence of undiagnosed infections exceeds 0.1%. Routine testing also decreases the stigma associated with HIV testing and relieves health care providers of the burden of deciding whom to offer screening to, a process often based on faulty risk assessment.
Test Miami address the goals of the National HIV/AIDS Strategy announced in July of this year:
1) reducing the number of people who become HIV- infected by allowing more people to be aware of their status and reduce their risk of transmitting to others,
2) increasing access to care and optimizing health outcomes for people living with HIV, by allowing persons with HIV infection to access healthcare earlier and
3) reducing HIV-related health disparities, by decreasing the rates of undiagnosed infections among African Americans.