Health professionals call for more HIV testing in Vermont

Published: May. 29, 2019 at 7:57 AM EDT
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Health professionals in Vermont say some patients are falling through the cracks when it comes to HIV testing, leading to patients coming to providers with full blown AIDs symptoms.

"We had a young man present to an emergency setting and he had a condition that appeared to the clinician as something that would be a condition that would be present in someone that didn't have an intact immune system," said Dr. Devika Singh at the University of Vermont Medical Center. "He was checked for HIV, and sure enough he was found to be HIV infected... it's the kind of pneumonia that we used to see in the 1980s."

In Vermont, the rate of HIV is anywhere from 100 to 130 per 100,000 people. The UVM Medical Center sees anywhere from 525 to 600 HIV patients. Singh says that number is "noticeable" for the Vermont population. But not every provider in the state tests everyone for HIV, something Singh says needs to change.

"We as a health care system, we as clinicians, have a lot to explain, to apologize to some of these families and communities about how we missed opportunities to test," Singh said.

According to the Vermont Department of Health, 70 percent of people diagnosed with HIV had a medical visit in the past year and weren't diagnosed.

"The more that we can make this routine. If testing for HIV can be as simple as measuring your height, your weight, finding out whether your cholesterol levels are at and your HIV status, I think we'd be going a long way," said Daniel Daltry with the Vermont Department of Health.

The CDC recommends everyone get an HIV test at least once in their life. Those who are at high risk, including men who have sex with men and those who use injection drugs, should be tested annually.

"It's a difficult burden to place it on patients for them to seek a primary care provider and ask for HIV testing, as far as we've come in the 30 odd years since HIV hit the map in the United States," said Singh. "It still carries a lot of stigma."

Though abstinence and no drug use are the only true ways to not transmit HIV, if the virus is found and being treated, it can become undetectable and thus untransferable.

Testing can be done through blood work but also through a rapid response test. Those who are at high risk can also take a drug called pre-exposure prophylaxis, or PrEP, which when used correctly, can reduce the risk of HIV by more than 92 percent. But doctors say there is still a long way to go with PrEP, as well.

"Overall across the country, PrEP utilization is fairly low, probably only achieving 10 percent of what we should be achieving in terms of PrEP in higher-risk populations," Singh said.

He says those on PrEP should be tested about every three months.