In Illinois, testing for HIV is on its way to becoming as routine as checking blood pressure or cholesterol.
Illinois — which has the sixth highest rate of new HIV cases in the nation — is approaching the third and final year of a federal grant aimed at reducing HIV/AIDS rates among racial minorities. Illinois was one of eight states to receive a grant from the Care and Prevention in the United States (CAPUS) Demonstration Project in 2012.
From March 2013 to June 2014, about 25,000 HIV tests were administered in Illinois, excluding Chicago, in relation to the CAPUS grant. Grant recipients expect to implement an additional 40,000 tests by September 2015, when the grant expires.
“The goal of the initiative is to destigmatize HIV and place sexual health higher on medical providers,” said Mildred Williamson, chief of HIV/AIDS for the Illinois Department of Public Health and the CAPUS lead in Illinois.
A primary goal of the initiative is to incorporate HIV testing into any visit to the doctor, such as a yearly physical or even an appointment for a sprained ankle, said Karen Reitan, executive director of the Public Health Institute of Metropolitan Chicago, one of the organizations to receive money from the grant.
“It’s about changing the culture in clinics so that HIV testing is normal,” Reitan said. In the past, HIV testing was more limited, she said. For instance, patients would have to ask to be tested.
The change is already underway in hospitals and clinics in areas where the HIV/AIDS incident rate is disproportionately high — namely, Chicago and the East St. Louis area.
The following neighborhoods are not represented on this map: East Garfield Park (Prevalent cases – 237, Prevalence rate – 1152.3); Forest Glen (Prevalent cases – 32, Prevalence rate – 172.9); Near North Side (Prevalent cases – 375, Prevalence rate – 465.9); Near West Side (Prevalent cases – 389, Prevalence rate – 708.8); South Lawndale (Prevalent cases – 559, Prevalence rate – 705); West Englewood (Prevalent cases – 311, Prevalence rate – 875.9); West Garfield Park (Prevalent cases – 201, Prevalence rate -1116.6)
Fifty-nine percent of all new HIV infections in Illinois in 2010 occurred in Chicago, and about half of all persons living with HIV in Chicago are African American, according to the Centers for Disease Control and Prevention. African American men who have sex with other men are the most affected group.
The IDPH received about $2.4 million for each year of the three-year project, Williamson said. Thirty-eight percent of that budget is allocated for community-based organizations throughout the state. There were a total of 24 recipients, including county jails outside Chicago, county health departments, university medical schools and other public health organizations.
Chicago grant recipients included the Public Health Institute of Metropolitan Chicago, Midwest AIDS Training and Education Center, the AIDS Foundation of Chicago and the Cook County South Suburban Ambulatory.
This is not the first initiative to promote routine HIV screenings, Williamson said of the CAPUS grant. However, the implementation of the Affordable Care Act may provide momentum to this change, she said.
Although the CDC in 2006 recommended HIV screening for all people ages 18-64, no state is required to incorporate HIV testing in routine health care, Reitan said.
Increasing the number of HIV screenings isn’t the only method the state is using to reduce HIV/AIDS mortality among racial minorities, Williamson said. IDPH is also using the CAPUS grant to develop more peer health navigators, improve data on HIV/AIDS data surveillance and reach out to LGBT youth.
Peer health navigators are trained community members who serve as liaisons between patients and medical service providers, said Simone Koehlinger, senior vice president of programming at the AIDS Foundation of Chicago. Their basic duties include providing educational materials and referring patients to doctors or medical centers.
“They identify newly diagnosed patients and link them to medical needs,” Koehlinger said. “They work to normalize this pathway to wellness. They live in high-incidence areas, they’re often HIV positive themselves.”
To increase accessibility to HIV and other STI testing and services, the health navigator organizations have to be part of the community where people live, Koehlinger said, and the organizations have to be led by community members.
“We have to empower communities,” she said. “We all have to work at this together.”
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Melanie Balakit is a recent graduate from the University of Maryland. Click here to learn more about her.