USA - Why aren’t Washington DC doctors testing for HIV?

Citation

(2011), "USA - Why aren’t Washington DC doctors testing for HIV?", International Journal of Health Care Quality Assurance, Vol. 24 No. 4. https://doi.org/10.1108/ijhcqa.2011.06224dab.005

USA - Why aren’t Washington DC doctors testing for HIV?

Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 24, Issue 4

Keywords: Chronic disease management, Healthcare screening programmes, Public/private healthcare partnership

HIV is a chronic, treatable disease. So why are DC residents showing up in ERs with AIDS diagnoses?

That’s the question Dr Lisa Fitzpatrick had after treating a 41-year-old patient who had been newly diagnosed HIV-positive through ER screening.

“Her immune system had been completely devastated by HIV,” said Dr. Fitzpatrick, who is an associate professor of medicine and practicing physician at Howard University Hospital. “It is likely that the ER routine HIV screening process saved her life. And her case isn't unique – there are many more avoidable cases like her who are diagnosed late.”

DC is facing a severe HIV epidemic – one that puts sexually active Washingtonians of every stripe at elevated risk for HIV. Yet, doctors in DC aren’t testing their patients for HIV. And that’s having serious consequences.

That is why the city is kicking off a new survey of every physician in DC, to find out just how much our doctors know, and do not know, about HIV testing and patient HIV risk-and to determine how the city can help.

The survey is part of an unprecedented effort to get every doctor in DC to offer routine HIV testing to their patients. The data that come out of the survey will help the city and its partners to refine physician programs, so that more doctors are familiar with current CDC and DC HIV testing guidelines and begin testing patients more routinely.

It is an approach that could help as many as 10,000 undiagnosed HIV positive DC residents get diagnosed, and get help.

Washington, DC has made tremendous progress in the fight against HIV/AIDS, especially thanks to the routine ER screening programs that saved Dr Fitzpatrick’s patient.

Now, the DC HIV/AIDS Administration is redoubling its outreach to private physicians, targeting DC’s 4,000 physicians through several new campaigns and partnerships.

One of the city’s physician-oriented programs is an innovative public-private partnership – Offer the Test – that links some unlikely partners in order to promote HIV testing in ways that are faster and cheaper than before.

Offer the Test enlists drug representatives from pharmaceutical firm Pfizer Inc to educate DC doctors about the city’s HIV epidemic and promote HIV testing during their regular meetings with them. A similar approach is now being piloted among medical students at George Washington University, who are educating their mentors – practicing physicians in DC.

“By leveraging partners like Pfizer and GW, the DC Department of Health will be able to reach a critical mass of doctors for a fraction of the cost,” said John Newsome, VP of the US HIV/AIDS Initiative at the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria, one of Offer the Test’s lead partners. “It’s an approach that will help us reach more people, more quickly and more effectively than ever before.”

The approach is breaking the mould for public-private partnerships-going beyond traditional philanthropy to engaging businesses where they can make the biggest possible difference.

For Pfizer, that means leveraging its sales representatives-who regularly meet with DC physicians-as educators and promoters of HIV testing.

New numbers released last year revealed that the HIV epidemic in DC was far worse than previously thought. Simply living in the District and being sexually active, it turned out, was enough to put residents at disproportionate risk for HIV infection.

More than 3 per cent of Washingtonians have been diagnosed with HIV. On top of that, it is possible that another 10,000 Washingtonians are positive and do not know it. Nationally, 21 per cent of HIV-positive people are unaware of their status; in DC, half of the city’s HIV-positive residents may not know their status.

Yet, officials at the Department of Health, physicians like Dr Fitzpatrick, and the Pfizer representatives taking part in Offer the Test all observe that many physicians do not seem aware of the risks their patients are facing, or how much routine HIV testing could help.

Ultimately, the city-wide survey and related physician outreach efforts could help fill those knowledge and implementation gaps.

For more information: www.gbcimpact.org