HIV Counseling and Testing

PROVIDER-RELATED SERVICES

In 2004, 31 percent of CARE Act providers (n=805) offered their clients HIV counseling and testing services, up from 28 percent (n=753) in 2002 (Table 15). These services include pretest counseling on the benefits of testing (including the medical benefits of diagnosing HIV disease in the early stages) and providing HIV antibody tests and posttest counseling (including the benefits of receiving early primary care intervention). Among providers in 2004, 48 percent (n=384) used CARE Act funds to provide these services, up from 43 percent (n=320) in 2002. About one-third, or 33 percent (n=266) of providers in 2004, offered partner notification services in 2004, down from 38 percent (n=283) in 2002.10

Table 15. CARE Act Providers and HIV Counseling and Testing Services: 2002, 2003, and 2004

Data on HIV counseling and testing services were missing for 1 provider in 2002.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2002, 2003, and 2004 CARE Act Data Reports.

CLIENT-RELATED COUNSELING AND TESTING CARE

Act providers offering HIV counseling and testing reported important utilization data concerning the clients receiving these services. The numbers of infants tested during 2004 was 15,461 (Table 15). The results from data from 2002 to 2004 demonstrate that CARE Act-funded counseling and testing sites are highly proficient at getting clients to return for test results, and at linking HIV-positive clients to care. In 2004, CARE Act providers delivered pretest counseling services to 854,229 clients, with 84.2 percent (n=719,076) receiving the services on a confidential basis and 15.8 percent (n=135,153) receiving the services anonymously (Table 16). Of all clients who received counseling services, 94.0 percent (n=802,599) were tested for the HIV antibody during the reporting period, up 2.5 percent over 2002. Among clients tested for the HIV antibody, 2.1 percent (n=16,793) tested positive for HIV antibodies, a slight decrease from the average of 2.3 percent in previous years.

CARE Act providers were also concerned with providing prevention and/or treatment services to individuals after testing. Results for the past 3 years suggest that CARE Act programs are successful in getting clients who are tested to return for their results. Providers reported that in 2004, 69 percent (n=553,569) of those who received HIV pretest counseling and testing returned for posttest counseling, an increase of 7.3 percent over the return rate in 2002.

The benefits of early diagnosis that are lost if clients do not return for test results are especially costly to clients who test positive for the HIV antibody. CARE Act providers reported that among their clients who tested positive for the HIV antibody, 85.3 percent returned for their test results or posttest counseling services, an increase of 2.1 percent from 2002 to 2004.

Closer examination of the results, specifically at programs that used CARE Act funds to provide counseling and testing, shows that 92.7 percent of clients who receive pretest counseling were tested for HIV, up from 91.3 percent in 2002. Of those clients who were tested, 70.2 percent returned for their test results and posttest counseling, an increase of 8.1 percent over the return rate in 2002. Service providers reported that 2.6 percent of clients tested were positive for HIV antibodies, a slight increase from the average of 2.4 percent in previous years. The return rate for positive clients was 88.2 percent in 2004, an increase of 5.9 percent from the average of 82.3 percent in previous years. These data show that CARE Act providers achieve high rates of testing clients and getting them to return for their results or posttest counseling. Further, providers who used CARE Act funds specifically to provide counseling and testing services captured more HIV positive clients and had greater success at getting them to return.

Table 16. Number of Persons Receiving HIV Counseling and Testing from CARE Act Providers: 2002, 2003, and 2004

Program Characteristics	2004		2003		2002
	Number	Percent	Number	Percent	Number	Percent
Received HIV pretest counseling	854229	100%	722188	100%	773170	100%
Received HIV pretest counseling and HIV test	802599	94%	673291	93.2%	707812	91.5%
Received HIV pretest counseling, HIV test, and posttest counseling	553569	69%	450928	67%	436661	61.7%
Received HIV pretest couseling and HIV test was positive	16793	2.1%	15505	2.3%	16691	2.2%
HIV test was positive; received posttest counseling	14326	85.3%	12558	81%	13053	83.2%

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2002, 2003, and 2004 CARE Act Data Reports.

10 Certain States and local jurisdictions mandate that only health department personnel perform partner notification activities. The data reported in the CADR may include information from Ryan White CARE Act providers who must refer partner notification activities to health department personnel for action.