Date of Report: 05/2006Source: National HIV/AIDS Clinicians' Consultation Center
Clinicians and hospitals are trying to make HIV testing a routine part of medical care. To implement these services, hospitals need to make clinical training in rapid and standard HIV testing a priority. While AIDS Education and Training Centers are already taking the lead in providing such training, the complexity of this subject and the need to individualize education and training approaches has become apparent. Trainers must provide guidance on selecting, administering, and interpreting rapid and standard HIV tests, and on understanding state laws as well as regional, state, and local approaches to these interventions.
Emergency departments, prenatal clinics, and labor and delivery units are the primary facilities currently under pressure to offer rapid testing, but primary care sites will soon need to become more active in offering routine HIV testing. Rapid testing is also becoming more widely offered in Ryan White-funded clinics and community health centers. Testing at these sites can prove vital to preventing transmission, yet routine HIV testing also raises many fundamental concerns about confidentiality and related issues. As routine rapid and standard HIV testing become more widely implemented, the healthcare workers involved in testing will also come from a broader range of disciplines, creating an increasingly complex environment for AETC trainers.
To support both AETC trainers and healthcare workers, the National HIV/AIDS Clinicians' Consultation Center (NCCC) is staffed to provide round-theclock, expert consultation to healthcare providers of all disciplines and training levels on topics including interpreting tests, presenting results, perinatal testing and procedure, and counseling patients. The NCCC website also provides a Compendium on State Laws: http://www.nccc.ucsf.edu/StateLaws/Index.html. In addition, the NCCC is pleased to support regional or local AETC trainers who encounter challenging questions in the course of providing their trainings. The NCCC can be reached for testing consultation in three ways.
The PEPline (1-888-448-4911) provides 24-hour expert guidance on managing healthcare worker exposures to HIV and hepatitis B and C. The PEPline provides a vital consultation link, particularly for emergency department providers faced with assessing the risk of occupational exposure to employees, including which tests to use to evaluate both the exposed healthcare worker and the source patient.
The Perinatal Hotline (1-888-448-8765) provides 24-hour advice on rapid and standard HIV testing in pregnancy as well as consultation on ARV use in pregnancy, labor and delivery, and the postpartum period. Common calls to the Perinatal Hotline regarding testing include questions about the interpretation of rapid tests in labor and delivery as well as advice on hospital protocols for testing
The Warmline (1-800-933-3413) provides clinical advice on HIV/AIDS management as well as prevention of transmission and proper use and interpretation of HIV tests. The service is available from 8 am–8 pm Eastern Time Monday–Friday assisting all clinicians including those with limited access to expert consultation and those with complex ARV resistance dilemmas.