Starting in late September, the Free Medical Clinic of Greater Cleveland will begin opt-out HIV testing for all patients. In 2006, CDC recommended all health care providers offer opt-out testing for patients ages 13-64 and all pregnant women.
In Cuyahoga County, 4,519 people are living with HIV/AIDS, according to the Cleveland Health Department. The Free Clinic has seen a steady rate of 20-30 people testing HIV-positive each year since 2006, according to HIV Outreach Manager Kalia Johnson. Last year the clinic diagnosed 23 people; all except one were black men who have sex with men and were ages 15-21. "If we test 200 people, we can count on about four of those people being positive," said Johnson.
Adriana Whelan, the clinic nurse practitioner, said, "If we do opt-out testing, in addition to clinical testing, which includes going out to high-risk communities, we may increase numbers for the clinic overall." The clinic will continue offering pre- and post-test counseling services.
Whelan said the Free Clinic will use the treatment-as-prevention approach. This method places patients on antiretroviral treatment as soon as they are diagnosed to reduce their viral loads and the risk of transmitting HIV.
The Free Clinic will continue its educational efforts targeting at-risk populations. "One thing I don't want to get lost is the prevention piece of it," said Johnson. "It's one thing to test someone; it's another thing to educate them."