The CDC's HIV testing recommendations advise routine HIV screening of adults, adolescents and pregnant women in health care settings in the United States. The UA's Section of Infectious Disease encourages individuals to know their HIV status through routine testing at one of the following:
Thirty years ago, an HIV diagnosis was often tantamount to a death sentence. But today, advances in medicine have drastically improved the outlook for those with the virus, especially when it is diagnosed and treated early.
The University of Arizona department of medicine's section of infectious disease, under the direction of Dr. Stephen Klotz, is working to address HIV cases very early on with help from a Health Resources and Services Administration grant for Ryan White services. Ryan White is a federally funded program that supports the core health needs of uninsured or underinsured individuals living with HIV or AIDS.
The $215,000 early intervention services grant, designed specifically to support efforts to detect and treat the virus in its earliest stages, is the second Ryan White grant awarded to Klotz, professor and chief of infectious disease. He also is a sub-recipient of a nearly half-million dollar grant supporting general aspects of HIV care and treatment.
The UA provides care for HIV-infected patients through its two Petersen Clinic locations, at The University of Arizona Medical Center-University Campus and The University of Arizona Medical Center-South Campus. The clinics serve both insured patients and patients eligible for services through the Ryan White program.
In operation since 2004, the Petersen Clinics have seen ample growth since 2010 when a second Ryan White medical provider in Tucson temporarily closed its doors to new patients and the University program simultaneously received additional funding to expand the scope of services available to patients. Since then, the clinics' overall patient population has increased from about 340 to more than 680. In the last 12 months alone, the clinics have welcomed more than 170 new patients, compared to 35-45 new patients in 2010.
"In Arizona, you have a large percentage of low-income, childless adults who do not qualify for Medicaid. As a result, there is a high level of uninsured individuals living with HIV and AIDS," said Shannon Smith, the Petersen Clinics' Ryan White program director. "Ryan White programming is here to assure those individuals maintain access to medical care, support services and medication."
As its patient population has grown, the UA has been awarded increased Ryan White funding, specifically for early intervention services. The goal of early intervention services is to identify individuals who are at high risk for HIV infection, such as partners of HIV patients, and connect with them with HIV testing, health education, counseling, community services and medical care.
In December, the University hired an early interventions coordinator to focus on that high-risk population as well as serve as an initial contact for all new HIV patients, including those referred by other physicians, by an emergency room or those who may have tested preliminary positive through rapid HIV testing, with an at-home test kit, and are looking to confirm their infection.
The goal is to connect with patients on a personal level and help guide them through all aspects of HIV care, providing information and connecting them to community resources and ongoing medical care.
"When you have that individualized connection with a patient, you can facilitate linkage to medical care in a way that is more expedited than having a patient figure out the system and make it on their own to the first medical visit," Smith said. "We're trying to keep everything as close to the medical provider as possible so that we can detect infection, start treatment early and ultimately improve the health outcome for the patient."
Early detection is made possible in part by the latest fourth-generation rapid HIV testing offered by the Petersen Clinics, which can detect the virus as early as 10 days after infection. Previous tests could not identify the disease earlier than three months post-infection.
More than 1.1 million people in the United States are living with HIV infection, and nearly one in five are unaware of their infection, according to the Centers for Disease Control and Prevention.
The Petersen Clinics' focus on early HIV detection and intervention falls in line with the national trend toward "prevention for positives," or educating the HIV-positive population, as opposed to the negative population, on how to maintain their health and prevent the virus from spreading.
Early intervention not only helps with prevention but can also improve overall health outcomes and quality of life for HIV-infected individuals, notes Dr. Anca Georgescu, assistant professor of clinical medicine and medical director for the Petersen Clinics.
"The most recent research data has shown that the earlier the treatment of HIV infection the better. They've shown that people with HIV develop certain other diseases, not associated with HIV traditionally – such as heart disease, osteoporosis, cancer – earlier in life compared to a non HIV-infected person, and early treatment may actually help," Georgescu said.
"The treatment regimens available now are much better tolerated, much easier to take and have much less side effects that the initial ones from the late '80s and early '90s, when the pills in themselves were toxic and had side effects," she added. "Now there's a few regimens that are only one pill a day with not a lot of restrictions, so quality of life is not impaired."