MMWR – Morbidity and Mortality Weekly Report

1. National HIV Testing Day — June 27, 2011 (Box)

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No summary available

2. Results of an Expanded HIV Testing Initiative — 25 Jurisdictions, United States, 2007–2010

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A CDC initiative tested nearly 2.8 million Americans for HIV and newly diagnosed more than 18,000 individuals. In 2007, CDC launched a three-year $102.3 million Expanded HIV Testing Initiative (ETI) in the 25 U.S. areas most affected by HIV. ETI is the largest CDC-funded effort to expand its HIV screening recommendations, which call for HIV testing to become a standard part of healthcare for all Americans. CDC funded health departments to increase HIV testing and facilitate linkages to care for disproportionately affected populations, particularly African Americans, who bear a greater burden of HIV than other races or ethnicities. Between September 2007 and October 2010, 2,786,739 tests were conducted, 18,432 persons were newly diagnosed with HIV and 75 percent of these cases, for whom follow up data was available, were linked to care. African Americans represented the majority of those tested (60 percent) and newly diagnosed (70 percent). Most HIV tests (90 percent) were conducted in healthcare settings. In 2010, CDC extended the effort based on early indications of its success. CDC estimates that 20 percent of the 1.2 million people living with HIV in the United States don’t know they are infected. Expanding testing is critical to help individuals receive life-extending treatment and protect the health of their partners.

3. HIV Screening of Male Inmates During Intake Medical Evaluation — Washington State Department of Corrections, 2006–2010

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A CDC study of Washington State Department of Corrections HIV testing records from 2006 to 2010 shows that offering voluntary, opt-out testing to inmates at intake can lead to a substantial increase in HIV testing and a higher rate of new diagnoses among an otherwise hard-to- reach population. Researchers compared data from January 2006 to August 2007 when the state offered HIV testing on a request-only basis and compared these data to records between September 2007 and March 2010, when the state changed its HIV testing policy to an opt-in strategy and again to records from March 2010 to December 2010 when the policy changed to an opt-out approach. Overall, there was an increase in HIV testing from 5 percent to 72 percent when the testing strategy changed from on request to opt-in. The opt-out approach further increased the uptake of HIV testing to 90 percent. The rate of newly diagnosed cases also increased from 1.8 cases per year when HIV testing was available only on request to 7.6 cases per year under the opt-out approach. The findings support CDC’s 2006 HIV testing recommendations, which call for all adults and adolescents to be tested as a routine part of medical care, regardless of risk, including those in correctional facilities. Researchers conclude that expansion of HIV testing within prisons has the potential to increase diagnoses of HIV infection and help stem continued transmission.

 

4. Ten Great Global Public Health Achievements ― 2001–2010

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This report assesses advances in public health during the first 10 years of the 21st century that illustrate the powerful impact core public health tools can have when applied effectively.
Worldwide, a child born in 1955 had an average life expectancy at birth of just 48 years. By 2000, the average life expectancy at birth had increased to 66 and, if past trends continue, is projected to rise to 73 by 2025. These improvements in longevity have resulted from improved living conditions overall, advances in medical science, and a number of population-level interventions. However, major disparities persist. During the last decade, in low-income countries, average life expectancy at birth increased from 55 to 57 years (3.6 percent), while increasing from 78 to 80 years (2.6 percent) in high-income countries. Like the recent MMWR report highlighting 10 public health achievements that occurred in the United States over the first 10 years of the new century, this report describes global public health achievements during the same period. Experts in global public health were asked to nominate noteworthy public health achievements that occurred outside of the United States during 2001–2010. From them, 10 were selected, and brief synopses are presented here. As with the previous report, the 10 global public health achievements are not ranked in order of importance.

 

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES