From the NY Times:
WASHINGTON — Federal health officials are preparing a plan to study a bold new strategy to stop the spread of the AIDS virus: routinely testing virtually every adult in a community, and promptly treating those found to be infected.
The strategy is called “test and treat,” and officials say the two sites for the three-year study will be the District of Columbia and the Bronx — locales with some of the nation’s highest rates of infection with human immunodeficiency virus.
The officials emphasize that this is just a first step. The goal is not to measure whether “test and treat” actually works to slow an epidemic, but whether such a strategy can even be carried out, given the many barriers to being tested and getting medical care.
On the path from infection to treatment, “we lose people at every single step,” said Dr. Shannon L. Hader, director of the H.I.V./AIDS administration at this city’s Department of Health.
As many as 5 percent of the adults in the District of Columbia are infected — a rate Dr. Hader says is comparable with those in West Africa — and one-third to one-half do not even know they harbor the virus. (Nationwide, 20 percent to 25 percent of people who are H.I.V. positive do not know of their infections, according to the federal Centers for Disease Control and Prevention.)
And even when infection is diagnosed, “getting people from the field to the doctor is the hardest component,” said Angela Fulwood Wood, deputy director of Family and Medical Counseling Service, an agency that operates a mobile H.I.V. testing clinic here. Often, she added, someone who has just tested positive “can walk off that day and decide, ‘I’m going to pretend that never happened.’ ”