National HIV Testing Day Highlights the Benefits of HIV Testing and Knowing Your Status

by Rick Haverkate, IHS National HIV/AIDS & HepC Program Coordinator

June 27 is National HIV Testing Day. On this day, we unite with federal and
tribal partners across the country to raise awareness about the importance
of HIV testing and early diagnosis of HIV. The Indian Health Service
recommends that everyone between the ages of 13 and 64 get tested for HIV
at least once as part of their routine health care. People at higher risk
should get tested more often.

The IHS, a primary partner in
Ending the HIV Epidemic: A Plan for America
, encourages early diagnosis and early entry into treatment, two major
factors in the elimination of the disease. Increasing the number of people
who are aware of their HIV status is a critical objective in reaching this
goal, so that people living with HIV can be linked to care and receive
treatment that reduces illness and transmission of the virus.

When a person receives a diagnosis early and carefully follows their HIV
treatment plan, they can achieve an undetectable level of HIV in their
blood, which can mean a full and healthy life. Getting to an undetectable
level of HIV also prevents sexual transmission of the virus to another
person. To promote this message, we use the term U=U, or
undetectable equals untransmittable.

An analysis from the Centers for Disease Control and Prevention
shows that about 80% of new HIV infections in the U.S. in 2016 were
transmitted from the nearly 40% of people with HIV who either did not know
they had HIV, or who had been diagnosed but were not receiving HIV care.
This underscores the impact of undiagnosed and untreated HIV and also the
critical need to expand HIV testing and treatment in the U.S.

In 2013, IHS and many tribal and urban Indian health care facilities
followed CDC recommendations in order to meet testing goals. IHS also broke
down barriers to testing by allowing other members of the medical team to
order HIV tests, rather than centralizing routine screening on just a few
health care providers. Finally, IHS added a ‘reminder’ to the electronic
health record that prompts a clinician to recommend an HIV test for
patients who had not previously been tested. These and other local changes
in policy and practice contributed to a steady increase in the proportion
of patients screened for HIV in IHS, tribal and urban Indian health
facilities.

Early detection and linkage to care may be helping.
Recent CDC data
shows a 30% decline in HIV deaths among American Indians and Alaska Natives
from 2014-2018. The new data indicates that the rate of deaths from HIV
among American Indians and Alaska Natives is now below that of whites in
the United States. While national statistics can often undercount American
Indians and Alaska Natives in the data, this decline is an encouraging
trend.

However, challenges remain. All IHS facilities, especially larger
hospitals, tend to see a plateau in HIV testing numbers. Testing in
emergency rooms and urgent care facilities is possible, but requires
staffing and other resources that often are not available. Due to the
COVID-19 pandemic, IHS is looking toward HIV self-testing, or home testing.
This not only reduces the stigma in testing, but allows for social
distancing and reduces the number of non-urgent patients in a clinic at any
given time.

We look forward to taking our success in HIV screening even further as we
move forward.

Related Content

Find a testing location near you

IHS HIV/AIDS Resources

CDC: Let’s Stop HIV Together

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