AETC Cross-Region HIV Testing Evaluation

Date of Report: 08/2008
Source: AETC National Evaluation Center

In September 2006, the Centers for Disease Control and Prevention (CDC) issued Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health Care Settings. Since the recommendations were released, the AETC network has worked to increase awareness of the new recommendations and improve capacity to conduct routine screening in various healthcare settings. Capacity-building activities have addressed a variety of topics including policies and procedures, systematized testing, rapid test interpretation, and prevention counseling.

In April 2008, the AETC National Evaluation Center (NEC) and AETC National Resource Center (NRC) contacted all regional AETCs to gather information on current HIV testing evaluation activities in order to develop a strategy for effectively communicating the results of these activities to Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) and CDC. Regions that had existing HIV testing evaluations in place shared their materials with the AETC evaluation community.

As a next step, the NRC and NEC began facilitating the development of a standardized cross-region HIV testing evaluation in collaboration with the regional AETCs and National Minority AETC. The purpose of this cross-region evaluation is to assess changes in the ability to provide HIV screening in clinics receiving enhanced capacity-building assistance as part of the AETC HIV Recommendations Training Initiative. After reviewing the various HIV testing evaluation materials submitted by regional AETCs, the committee is taking inspiration from Pacific AETC (PAETC) and Pennsylvania/MidAtlantic AETC.

To assess the capacity of clinics for conducting HIV testing, most regions will employ PAETC's organizational assessment tool. The assessment tool will be administered to clinic staff by central office or local performance site (LPS) evaluators before and after a capacity-building assistance intervention conducted at one of the following settings: primary care, emergency room, or labor and delivery. Some of the HIV testing aspects addressed in the organizational assessment include:

	Existence of written HIV testing policies and procedures
	Integration of HIV testing into regular patient check-ups
	Opt-out HIV testing
	Rapid testing
	Patient consent
	Mechanism for providing test results to patients
	Distribution of patient education material
	Availability of appropriate medication
	Follow-up counseling and referrals

In addition to using the PAETC evaluation tool, most regions will also collect data on the frequency of HIV tests delivered at participating clinics. This clinic-level capacity-building evaluation will also be enhanced, on an optional basis, with individual-trainee-level data collected using the qualitative behavior change method and/or with supplemental qualitative data collection (two AETC regions are presently engaged in enhanced qualitative evaluation). The qualitative behavior change method consists of a set of open-ended questions, based on response logic, which ask about whether trainees have been able to apply the information learned.

All regional AETCs and the National Minority AETC will begin implementing this cross-region HIV testing evaluation plan on September 1, 2008.