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Hiv Testing Reflection

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In August 2009, the VA policy for HIV testing was revised from “risk-based” testing to routine HIV of all Veterans regardless of risk factors. Written informed consent was no longer needed, but verbal consent was still required. Initially, this change in policy was not well received. Already overburdened primary care physicians were complaining about workload issues and assumed that routine testing would result in minimal yield. There were many misconceptions that even educated health care providers believed. My job was to implement this new policy change and my vision was to increase (at least double) the number of Veterans with a documented HIV test. As the agency lead for HIV programs, this was a major challenge because the …show more content…

First, I needed to tackle a culture change among VA primary care providers that would require some innovation and creativity. Many needed convincing that risk-based testing was missing many Veterans who may be infected with HIV. Even though, many scientific studies have shown that this approach misses many who may be HIV positive and can lead to late diagnosis and worse morbidity – the science alone was not convincing these providers that the policy change was needed. I needed to utilize my interpersonal skills, written communication, and creativity to accomplish my goal. Ironically, even though many providers preferred risk based testing many of these same providers did not feel comfortable discussing risk factors and often avoided the subject with their patients. Therefore, these providers were only testing Veterans who self- disclosed risk …show more content…

I helped create a large creative public health/social media campaign across the VA titled “Say Yes to the Test” that focused on changing attitudes of Veterans toward routine HIV testing and increasing acceptance of the test. Videos, posters, pins, and other written and visual messages were spread throughout all the VA Medical Facilities - encouraging Veterans to ask their providers to be tested for HIV. Additionally, VA expanded National HIV Testing Day to National HIV Testing Week to encourage as many Veterans as possible to get tested. We utilized social media – facebook, twitter, and others to get the message out to the Veterans. We also changed the language the providers used to offer HIV tests to be inclusive of all routine screening. For example, I convinced providers to change the approach to offering a test and incorporating it to their routine testing language by saying – “VA is now recommending that all Veterans be screened for cholesterol, diabetes, and HIV – would you like me to screen you for these things

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