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PSR | 2013



HIV and AIDS remain a persistent problem for the United States. In 2010, the White House released the first National HIV/AIDS Strategy for the United States to increase the nation’s sense of urgency and improve the response to the ongoing HIV epidemic.1

The Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of three key policies and practices that state health departments can use to improve the health of people living with HIV infection and prevent the spread of HIV:  

These policies and practices reflect recent scientific advances in HIV prevention and medical care, create new opportunities for substantially reducing new HIV infections and HIV-related illness and death, and are important state-level tools that further the goals of the 2010 National HIV/AIDS Strategy.1


Policies & Practices

State Medicaid reimbursement for routine HIV screening

CDC and the US Preventive Services Task Force recommend that adolescents, adults, and pregnant women be screened for HIV, regardless of risk.3,4

Facilitating state Medicaid reimbursement of healthcare providers for routine HIV screening helps further the goals of the 2010 National HIV/AIDS Strategy.1 One goal of the strategy is to ensure that by the year 2015, 90% of people living with HIV know their infection status.1 Early HIV diagnosis is important for preventing new HIV infections and ensuring that people with HIV are able to receive medical care that will improve their health and reduce the risk of premature death.4,5 All state Medicaid programs cover medically necessary HIV testing. The Centers for Medicare & Medicaid Services encourages state Medicaid programs to reimburse for routine HIV screening regardless of risk.6 Reimbursement increases the availability of routine HIV screening for low-income populations.3,7

Status of state Medicaid reimbursement for HIV screening, United States (as of January 1, 2013)


Bar chart showing Status of state Medicaid reimbursement for HIV screening, United States (as of January 1, 2013). Green: 32 state Medicaid programs reimbursed for routine HIV screening of adults aged 15-65 years, regardless of risk. Red: 13 state Medicaid programs did not reimburse for routine HIV screening of adults aged 15-65 years, regardless of risk. Data were not available for 6 states. (State count includes the District of Columbia.)

(State count includes the District of Columbia.)


± How the ratings were determined

States were rated green or red according to the following criteria:

Green

As of January 1, 2013, the state Medicaid plan reimbursed for routine HIV screening of adults aged 15-65 years, regardless of risk.

Red

As of January 1, 2013, the state Medicaid plan did not reimburse for routine HIV screening of adults aged 15-65 years, regardless of risk.

± More information on this indicator

 

State HIV testing laws

Making state HIV testing laws consistent with CDC’s 2006 HIV testing recommendations helps further the goals of the 2010 National HIV/AIDS Strategy.1 HIV testing enables individuals with HIV to become aware of their health status and to access medical care and treatment. Studies show that individuals who know they have HIV are less likely to trans­mit the virus to others.1 State laws can facilitate access to HIV testing.

Status of state HIV testing laws, United States (as of July 2013)


Bar chart showing Status of state HIV testing laws, United States (as of July 2013). Green: 49 states had HIV testing laws that were consistent with consent and counseling parameters in CDC’s 2006 HIV testing recommendations. Red: 2 states had HIV testing laws that were inconsistent with CDC’s 2006 HIV testing recommendations on one or more parameters. (State count includes the District of Columbia.)

(State count includes the District of Columbia.)


± How the ratings were determined

The following parameters of state HIV testing laws were assessed:

  • Consent parameters:
    • Opt-out (rather than opt-in) testing
    • Inclusion of HIV testing consent as part of general medical consent forms (rather than HIV-specific consent forms)
    • Permission to give consent orally
  • Counseling parameter:
    • Not requiring HIV prevention counseling prior to testing

 States were rated green or red according to the following criteria:

Green

As of July 2013, the state HIV testing laws were consistent with consent and counseling parameters of CDC's 2006 HIV testing recommendations.

Red

As of July 2013, the state HIV testing laws were inconsistent with consent or counseling parameters in CDC's 2006 HIV testing recommendations.

± More information on this indicator

 

Reporting of CD4 and HIV viral load data to state HIV surveillance program

Reporting all CD4 and HIV viral load results (detectable and undetectable) to the state HIV surveillance program helps further the goals of the 2010 National HIV/AIDS Strategy.1

CD4 and HIV viral load data are critical to the medical care and health of people living with HIV. These  data are used to ensure that people with HIV are linked to and retained in medical care, which improves their health and prevents new HIV infections by controlling the virus and reducing the risk of HIV transmission.5

An HIV viral load test measures the amount of virus in a person’s blood. A CD4 lymphocyte count provides a measure of a person’s immune function and is used for determining the stage of HIV infection. Among people with HIV, CD4 results are often used to monitor disease progression and to time clinical care, and both HIV viral load and CD4 results are used to assess response to treatment.

Status of reporting of CD4 and HIV viral load data to state HIV surveillance program, United States (as of July 2013)


Bar chart showing Status of reporting of CD4 and HIV viral load data to state HIV surveillance program, United States (as of July 2013). Green: 37 states required reporting of all CD4 and HIV viral load data . Yellow: 14 states required reporting of some but not all CD4 and HIV viral load data . Red: 0 states did not require reporting of any CD4 and HIV viral load data. (State count includes the District of Columbia.)

(State count includes the District of Columbia.)


± How the ratings were determined

States were rated green, yellow, or red according to the following criteria:

Green

As of July 2013, state law, regulation, or directive required reporting of all CD4 and HIV viral load data.

Yellow

As of July 2013, state law, regulation, or directive required reporting of some but not all CD4 and HIV viral load data.

Red

As of July 2013, state law, regulation, or directive did not require reporting of any CD4 and HIV viral load data.


 

Prevention Status Reports: HIV, 2013

The files below are PDFs ranging in size from 100K to 500K.

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming


References

  1. White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States [PDF 1.36MB]; 2010.
  2. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2011 [PDF 1.07MB]. HIV Surveillance Supplemental Report 2013;18 (No. 5).
  3. CDC. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR 2006;55(RR-14):1-17.
  4. Moyer VA, on behalf of the U.S. Preventive Services Task Force. Screening for HIV: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine 2013; Apr 30.
  5. CDC. Vital Signs: HIV prevention through care and treatment—United States. MMWR 2011;60(47):1618–23.
  6. Centers for Medicare & Medicaid Services. Letter to State Health Officials [PDF 56.7KB]. Jun 24, 2009.
  7. Kates J. Medicaid and HIV: A National Analysis [PDF 1.57MB]. Menlo Park, CA: Kaiser Family Foundation; 2011.

 

 

 
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