AIDS Education and Prevention, 23(3) Supplement, 1–6, 2011 © 2011 The Guilford Press Stein et al. Introduction to Special Supplement
INTRODUCTION TO SPECIAL SUPPLEMENT
MONITORING AND EVALUATION OF HIV COUNSELING, TESTING AND REFERRAL (CTR) AND HIV TESTING SERVICES Renee Stein, Tanisha S. Grimes, Robert Malow, Dale Stratford, Freya Spielberg, David R. Holtgrave The Centers for Disease Control and Prevention (CDC) estimate that 1.1 million people are living with HIV in the United States and approximately 56,000 new infections occur each year (CDC, 2008; Hall et al., 2008). By the end of 2006, an estimated 21% of people with HIV did not know that they were infected (calculated using extended back-calculation methods) (Campsmith et al., 2010). Many of those who do learn their serostatus are diagnosed in the late stages of the disease—approximately 38% of those who are diagnosed with HIV progress to AIDS within a year of their first positive HIV test. HIV transmission rates from persons who are aware of their seropositivity is approximately 3.3 compared to a rate of approximately 11.4 of those unaware of their seropositivity (Holtgrave, 2010). Furthermore, with high-quality care, a 25-year-old HIV-positive person can live an additional 39 years (Lohse, 2007). This information confirms the importance of routine HIV testing and early linkage to care for persons who test positive (CDC, 2009). Two of the primary goals of the 2010 White House National HIV/AIDS Strategy (NHAS) are to reduce new HIV infections and to increase the access to and quality of care of those who are infected (Millet et al., 2010). HIV testing is an important strategy to reach these goals since people who do not know their serotatus are more likely to engage in risk behaviors that transmit HIV to others (Hall et al., 2010) and may access care too late to receive the maximum benefit (Hall et al., 2010). One of the targets set forth by the NHAS is to increase the percentage of people who are living with HIV who know their serostatus from 79% to 90% by 2015. The NHAS also calls for the development of improved mechanisms to monitor and evaluate efforts to reduce HIV incidence and improve health outcomes. It is particularly important during this difficult economic time to conduct high-quality monitoring and evaluation of HIV testing so that resources may be properly allocated to HIV testRenee Stein, Tanisha S. Grimes, and Dale Stratford are with the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention (CDC), Atlanta, GA. Robert Malow is with the College of Health and Urban Affairs, Florida International University, North Miami, FL. Freya Spielberg is with the Research Triangle Institute, Research Triangle Park, NC. David R. Holtgrave Department of Health, Behavior and Society and Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Address correspondence to Renee Stein, PhD, MPH, Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mail Stop E-59, Atlanta GA 30333; E-mail: arf7@cdc.gov
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