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Sunday, June 25, 2006 - Page updated at 12:00 AM


D.C. plans mass HIV testing

The New York Times

WASHINGTON — The District of Columbia, with the nation's highest rate of new AIDS cases, is beginning a campaign to screen every resident 14 to 84 for HIV, the virus that causes AIDS.

The campaign will target 400,000 men, women and teenagers and encourage them to learn their HIV status through an oral swab that delivers results in 20 minutes.

D.C. health officials said the campaign, if successful, would be the most aggressive screening regimen undertaken in the history of the 25-year-old AIDS epidemic. It comes amid an increased push from federal officials to make HIV tests, which concentrate on high-risk groups, a routine part of medical exams, such as tests for cholesterol or high blood pressure.

A recommendation being considered by the federal Centers for Disease Control and Prevention (CDC) urges doctors to routinely screen every patient 13 to 64.

"This is cutting edge," said Dr. Gregg Pane, director of the Department of Health for the District of Columbia. "I'm not aware of any city that has launched an effort this comprehensive."

About 43,000 Americans became infected with HIV in 2004, less than half as many as contracted the virus at the height of the epidemic. But despite extensive public-awareness campaigns, public-health officials have been unable to lower the number.

Expanded screening may help, since studies have shown most people who are aware they carry the virus take measures to avoid infecting others.

It also could save lives, since early treatment can greatly delay, or perhaps forestall, the onset of AIDS. The CDC estimates 1 million Americans carry the virus and about 250,000 of the million do not know it.

But the push for expanded testing has raised concerns among some advocates for people with AIDS. They worry that breaches of confidentiality may lead to people with HIV or AIDS being stigmatized or punished, with a loss of jobs, housing or insurance.

About 10,000 D.C. residents — 2 percent of the population — have AIDS. Nearly 180 of every 100,000 residents are infected with the disease each year, while the average state has a rate of about 15 new cases per 100,000 people.

After a critical report last year on D.C.'s HIV/AIDS administration programs, Pane fired the administrator and hired a replacement, Dr. Marsha Martin, who will oversee the new campaign. Martin previously ran an advocacy group called AIDS Action.

The campaign, disclosed Saturday by The Washington Post, is expected to start Tuesday. It will distribute about 80,000 oral tests this year to doctors' offices and community groups.

Unlike earlier tests, which took about two weeks to produce results, these work in about 20 minutes. That is significant because many people who underwent the earlier tests never returned to learn the results.

One recent federal study of HIV screening found that about 1.2 percent of those tested had the virus.

Pane said he agreed with advocates who warned that the testing regimen needed to include counseling and medical referrals for those with the virus. The city will spend about $8 million on the program, he said, some of which can be used for that purpose.

In the long term, he said, he hoped the testing and the treatment referrals would occur inside the D.C. general health-care system.

Material from The Washington Post is included in this report.

Copyright © 2006 The Seattle Times Company




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