A Novel Approach to Realizing Routine HIV Screening and Enhancing Linkage to Care in the United States: Protocol of the FOCUS Program and Early Results.

Travis H Sanchez,Angela F Wood,Lisa K Fitzpatrick,Emily H Brown,Paloma I Hernandez,Patrick S Sullivan,Amy S Nunn,Richard E Rothman,Lisa Moreno-Walton,Martin L Serota

doi:10.2196/resprot.3378

Abstract

BackgroundThe United States health care system remains far from implementing the Centers for Disease Control and Prevention's recommendation of routine human immunodeficiency virus (HIV) screening as part of health care for adults. Although consensus for the importance of screening has grown, innovations in implementing routine screening are still lacking. HIV on the Frontlines of Communities in the United States (FOCUS) was launched in 2010 to provide an environment for testing innovative approaches to routine HIV screening and linkage to care.ObjectiveThe strategy of the FOCUS program was to develop models that maximize the use of information systems, fully integrate HIV screening into clinical practice, transform basic perceptions about routine HIV screening, and capitalize on emerging technologies in health care settings and laboratories.MethodsIn 10 of the most highly impacted cities, the FOCUS program supports 153 partnerships to increase routine HIV screening in clinical and community settings.ResultsFrom program launch in 2010 through October 2013, the partnerships have resulted in a total of 799,573 HIV tests and 0.68% (5425/799,573) tested positive.ConclusionsThe FOCUS program is a unique model that will identify best practices for HIV screening and linkage to care.

Highlights

8 years after the Centers for Disease Control and Prevention (CDC) recommended routine human immunodeficiency virus (HIV) screening for all Americans aged 13-64, the US health care system continues to struggle to make progress in meeting this important public health recommendation [1]
Program Overview The Frontlines of Communities in the United States (FOCUS) program has been implemented in Atlanta, Baltimore, Chicago, Los Angeles, Houston, Miami, New Orleans, New York City, Philadelphia, and Washington, DC (Figure 3)
FOCUS partnerships have resulted in 799,573 HIV tests being conducted with 0.68% (5425/799,573) persons testing positive

Summary

Introduction

8 years after the Centers for Disease Control and Prevention (CDC) recommended routine human immunodeficiency virus (HIV) screening for all Americans aged 13-64, the US health care system continues to struggle to make progress in meeting this important public health recommendation [1]. Identifying innovative and robust approaches to reaching the large numbers of undiagnosed people living with HIV and doing so in a way that reaches them earlier in the course of their disease is key to making progress toward achieving viral suppression and providing its attendant clinical and prevention benefits. These approaches will need to substantially transform how we conduct HIV screening in clinical settings, but will need to address how the community as a whole responds to HIV screening and care. Conclusions: The FOCUS program is a unique model that will identify best practices for HIV screening and linkage to care

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Results

Conclusion