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Many with HIV don't know it

Aggressive new HIV testing is identifying more people infected with the virus, but more than 20 percent of those infected still don't know it.
BY FRED TASKER, ftasker@MiamiHerald.com

In 2006, nearly 25 percent of the 60,000-plus Americans who had newly contracted the HIV virus were not aware of it, and thus weren't getting treatment or protecting their sexual partners. Today it's 21 percent -- an improvement, but nowhere near enough, said speakers at an HIV/AIDS conference in Washington, D.C., on Thursday.

''It's crucial to understand how important routine HIV testing is at every level of American society so everyone knows their status; it's the first step in controlling the HIV epidemic,'' said Dr. Veronica Miller, executive director of the Forum for Collaborative HIV Research.

In Florida, new testing programs are helping, but also are not enough, state health officials say.

New HIV cases in the United States continue at a relatively stable rate of more than 60,000 per year, according to studies prepared for the forum. It means 1.1 million Americans are living with HIV, and as many as 250,000 don't know it.

In 2006, the U.S. Centers for Disease Control and Prevention set new goals, urging routine HIV testing for all of those from 13 to 64.

''Testing should be as routine as flu shots,'' she said.

In Florida, new HIV testing sites have been set up in nine major hospitals, three community health centers, 10 clinics for sexually transmitted diseases and 10 correctional facilities, according to a summary of a paper prepared by Tom Liberti, chief of the Bureau of HIV/AIDS of the Florida Department of Health. The summary did not list the hospitals or health centers and the state agency did not have information about them.

Between October 2007 and July 2008, the Florida programs tested 43,481 individuals for HIV, identifying 1,042 people infected, the report said. The goal is to test 150,000 a year. Liberti could not be reached for comment.

Miami-Dade's four sexually transmitted disease clinics test about 16,000 patients a year for HIV, said their medical director, Dr. Jose Castro, a University of Miami infectious disease doctor.

Until recently, it took two weeks to get the results of HIV tests and many patients failed to come back for the results. Now the clinics have instant HIV-testing kits.

''They can learn their status before they leave,'' Castro said, ``and we can get them into treatment.''

Jackson Memorial Hospital and the University of Miami Hospital test only a small percentage of patients who go through their emergency rooms.

Baptist, South Miami, Doctors, Homestead and Mariners' hospitals are not part of Liberti's nine-hospital program. And walk-in HIV testing is not offered in their emergency rooms, though anyone treated for diseases or accidents is offered the testing. ''If any patient asks, or if what he says to the doctor raises the possibility, we offer it,'' said Barbara Russell, director of infection control for the above hospitals. The hospitals also offer the same-day testing.

Conference members detailed the crisis:

• 50 to 70 percent of new HIV cases were spread by people who did not know they were infected.

• Even among patients seeking treatment for sexually transmitted diseases -- a high-risk population -- only 36 percent are tested for HIV.

• Even though new drugs can greatly reduce the rate of mother-to-child transmission at birth, only 59 percent of pregnant women are tested for HIV.

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