Ten Sites, 10 Years, 10 Lessons: Scale-up of Routine HIV Testing at Community Health Centers in the Bronx, New York

Area of Science:

• Public Health
• Infectious Disease Prevention
• Healthcare Management

Background:

• Routine HIV testing is recommended by the CDC in clinical settings.
• Populations at higher risk for HIV/AIDS require accessible testing services.
• The Adolescent AIDS Program developed the Advise, Consent, Test, Support (ACTS) model in 2003.

Purpose of the Study:

• To evaluate the effectiveness of the ACTS model in increasing routine HIV testing.
• To assess the impact of the ACTS model on HIV testing rates and linkage to care.
• To determine if the ACTS model can be implemented without additional personnel or financial resources.

Main Methods:

• The ACTS model streamlined counseling and testing processes.
• A practice change plan, training, and communication materials were provided.
• Key metrics included patient numbers, HIV test eligibility, testing rates, results, and linkage to care.

Main Results:

• HIV testing rates in 10 community health centers increased from 8% in 2003 to 28% in 2013.
• Over 433 HIV-positive patients were identified between 2006 and 2013.
• 96% of HIV-positive patients were linked to care within 90 days of diagnosis.

Conclusions:

• The ACTS model significantly increased sustained routine HIV testing in healthcare settings.
• The model's success was attributed to its practice change plan and streamlined approach.
• Implementation did not require additional personnel or financial resources.