2.1 Making Services Available to All HIV-infected Persons
All CDC funded HIV prevention counseling and testing sites, both
confidential and anonymous, must make PCRS available to all HIV infected
persons. |
People can learn
that they are HIV-infected through a variety of sources,
including confidential and anonymous testing sites, private
care physicians, or home collection kits. However, regardless
of where and how persons have been tested, PCRS must be made
easily accessible to all HIV-infected persons. For example, an
HIV-infected person who has been tested by a private provider
might seek services from a CDC-funded provider.
Although verified evidence of HIV infection
should always be presented to the PCRS
provider before partners are contacted,
PCRS must be made available to the HIV-infected
person.
The client who has just been informed of
being HIV-infected will, of course, need to
have PCRS offered at the earliest appropriate
time, but the PCRS provider will encounter
many others to whom services should be
offered. For example, those persons could
include a previously identified HIV-infected -
- client who in the past was not offered PCRS;
- sex or needle-sharing partner who the
PCRS provider learns is continuing to
have unprotected sex and who has
partners other than the original HIV-infected
client;
- client who now has new sex or needle-sharing
partners;
- client who is now seeking additional STD
or family planning services or substance
abuse treatment; or
- client who in the past refused or only
partially participated in PCRS but has
now decided to participate fully.
Health department HIV prevention program
staff should ensure that health care and prevention
providers in the community and HIV-infected
persons in the area are aware that
PCRS is available at publicly funded sites and
are aware of how to access those services.
Furthermore, health departments can expand
access to PCRS by developing agreements with
private providers. These agreements could
specify that the private providers will deliver
PCRS to their HIV-infected clients. In such
situations, these providers should be given
relevant information, training, and support to
successfully deliver the services.
2.1.1 Services for Those Persons Tested Anonymously
CDC-funded programs must
provide access
to PCRS for
persons testing
anonymously
without
requiring that
the infected
client disclose
his or
her identity. |
Opportunities to
access PCRS must be
provided to HIV-infected
clients who
have been tested
anonymously and
choose to remain
anonymous. Program
experience has indicated
that PCRS can
be conducted in an
anonymous setting
(Hoffman, et al., 1995). CDC requires that,
unless prohibited by state law or regulation,
grantees must provide reasonable opportunities
for anonymous testing. Clients who test
HIV-positive in anonymous settings must be
counseled on how to enter a confidential
system and be strongly encouraged to do so.
This will assist them in receiving medical care
and other services, including PCRS.
Recent reports show that persons who enter
anonymous HIV testing programs do so
earlier in their HIV infection and are more
likely to begin medical care while still comparatively
well (Bindman et al., 1998;
Nakashima et al., 1998). CDC currently recommends
that persons initially testing positive
for HIV in an anonymous setting be counseled
and informed about how to enter a confidential
medical care system.
2.1.2 Inability To Pay
CDC-funded PCRS programs must
provide access to PCRS regardless of clients' or
partners' ability to pay (CDC, 1993).
2.2 Accommodating Requests from Other Health Jurisdictions
Requests for PCRS from other health
jurisdictions must be accommodated whenever practical. |
PCRS providers
might sometimes be
asked to contact the
partner of an HIV-infected
person residing
in another health jurisdiction.
Such contacts
with other jurisdictions
is the role of the state
health department. For example, a PCRS
provider might request that the staff in a neighboring
state health department assist in locating
and informing a previous partner or former
spouse of an HIV-infected client. A reasonable
effort must be made to accommodate that
request if it complies with state and local
regulations and policies, and confidentiality
is maintained.
Go to Section 3.0 |