02/18/10

PRN Report from 17th CROI:  Testing and Transmission

Access to increased HIV testing, entry into HIV care, and funds for anti-retroviral (ART) were discussed in two oral abstracts at the 17th Conference on Retroviruses and Opportunistic infections Wednesday in San Francisco, CA. The impact of widespread HIV testing and success to healthcare and medications were shown to decrease transmission of HIV in two fascinating presentations.

Dr. Moupali Das presented data from the San Francisco department of Health that looked at the “temperature of the community” by developing a method to follow the community viral load (CVL) and the impact of reduction of CVL will have on overall reduction of HIV transmission. The data suggested that there was a trend for reduction of the CVL between the years 2004-2008 likely related to increased potency of ART and increased knowledge of HIV status within the community. The decline in CVL was associated with decrease in newly diagnosed HIV infections over the same period of time. This data is suggestive that management of the CVL will have an upstream impact of HIV infections within that community.

Dr. Amanda Castel from the Washington DC department of health (DCDOH) presented data on the initiation of “opt-out” HIV testing in Washington DC. Since 2006, the DCDOH has been conducting a scale up of routine HIV testing. Increased funding for rapid HIV testing and educational campaigns for the community and medical providers in DC has been provided during this “opt-out scale up.” Since the initiation of the program HIV testing has increased from 19,766 tests in 2004 to 72,866 tests in 2008. Entry into care was less than 3 months after diagnosis for 80.2% of participants in 2008 compared with 66.7% in 2004. Additionally, progression to AIDS was reduced from 46.7 % in 2004 to 27.7% in 2008.

Both of these presentations demonstrated the continued need for increased allocation of funds for HIV testing and medical provider education, quick entry into care for newly diagnosed HIV infected individuals and funding for aggressive management with ART within the community will have beneficial effects of reduction of the spread of HIV.

Reference:
Moupali Das-Douglas, et al. Decreases in Community Viral Load Are Associated with a Reduction in New HIV Diagnoses in San Francisco. Presented at 17th Conference on Retroviruses and Opportunistic Infections 2010; San Francisco, CA. Oral Abstract 33.
Amanda Castel, et al. Monitoring the Impact of Expanded HIV Testing in the District of Columbia Using Population-based HIV/AIDS Surveillance Data. Presented at 17th Conference on Retroviruses and Opportunistic Infections 2010; San Francisco, CA. Oral Abstract 34.

Source: Reporting from San Francisco for PRN News: A.C. Demidont, DO