HIV testing trends before and after legislation mandating an offer of HIV testing in New York City
Tuesday, November 5, 2013
: 11:15 a.m. - 11:30 a.m.
Background: In 2006, the Centers for Disease Control and Prevention recommended opt-out HIV screening for individuals ages 13-64 in healthcare settings. At that time, New York State did not allow opt-out testing. Effective September 2010, new legislation expanded consent options and made New York the first to mandate an HIV test offer to all patients ages 13-64 in healthcare settings, with limited exceptions. Objective: Assess HIV testing rates among New York City (NYC) ambulatory practices before and after changes in New York State (NYS) legislation mandating an offer of HIV testing in clinical settings. Methods: The NYC Department of Health and Mental Hygiene obtained quarterly HIV testing rates at 218 ambulatory practices. Testing rates were stratified by age, from 2009 to 2011. Rates were calculated as number of patients with HIV test results over patients with visits during the same time period. Odds ratios were obtained using longitudinal modeling. Results: HIV testing rates improved after the law took effect. Odds of testing increased 200% from Q3 2010 to Q4 2011 (OR: 2.05, 95% CI: 1.16, 3.65), compared to a 7% increase during the pre-law year (Q4 2009-Q3 2010) (OR: 1.07, 95% CI: 0.88, 1.30). Improvements persisted after adjusting for age, practice type, location and baseline performance. Discussion: This evaluation found significant improvement in HIV testing rates after NYS enacted new legislation mandating an HIV test offer, particularly in age groups targeted by law. However, testing mandates should be coupled with other efforts to increase testing rates on a large scale.
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Public health or related public policy
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Describe HIV testing trends in New York City before and after a change in HIV law which mandated the offer of an HIV test in healthcare settings
Keyword(s): HIV/AIDS, Policy/Policy Development
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I am the Director of HIV Testing, HIV AIDS Prevention at the New York City Department of Mental Hygiene, in the Department of HIV AIDS Prevention. I have overseen multiple interventions to increase HIV testing in New York City and partnered with the Primary Care Information Project, an external Bureau of the Health Department, to conduct an evaluation of the change in HIV testing over time.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.