One of the most problematic barriers in health care is the time and effort it takes to translate the latest research into real-life clinical applications, ensuring all health institutions’ uniform compliance with newly-set standards. Seeing clinical updates through to completion and application is especially crucial in contagious diseases, such as HIV.
The Centers for Disease Control and Prevention are responsible for periodically releasing new guidelines for HIV diagnostics and management, but a recently completed survey revealed healthcare institutions in Houston and Washington, D.C. are not compliant with the latest CDC guidelines for HIV testing, which could mean missed diagnoses. The findings are available in PLOS ONE, from a group of scientists at Baylor College of Medicine, the Milken Institute of Public Health (Milken Institute SPH) at the George Washington University, and the Houston Department of Health and Human Services (HDHHS).
Associate professor of medicine and infectious diseases at BCM, Dr. Thomas Giordano, explained that HIV patients respond much better to treatment the earlier they are diagnosed. Prompt and accurate testing is also fundamental to containing the virus, thereby protecting patients’ friends, family, and attending healthcare providers. Ensuring the latest guidelines are followed uniformly across the country is as much of an individual concern as it is a public health issue.
It was in 2006 when the CDC last published guidelines for HIV testing, which made it routine in adult and adolescent patients, and did away with the requirement for written consent. Pre- and post-test counseling is no longer mandatory.
When the researchers surveyed hospitals, outpatient clinics, and designated HIV and substance abuse centers, they discovered half of them were still using outdated guidelines and lacked a written policy for HIV testing. This prompted the HDHHS to offer technical assistance to the participating facilities.
Marlene McNeese, the chief for the Bureau of HIV/STD and Viral Hepatitis Prevention at the HDHHS, said that Houston may already be significantly behind the rest of the country’s rate of HIV testing. She suggests a city-wide audit of CDC guidelines compliance. Michael Kharfen, the senior deputy director for the District of Columbia Department of Health HIV/AIDS, Hepatitis, STD and TB Administration, said that there is much to be done before HIV testing becomes as routine as checking blood pressure and getting a lipid panel.