A program at the University of North Carolina at Chapel Hill School of Medicine that integrates HIV prevention efforts into regular care for HIV-positive patients has received a $1.8 million grant from the Centers for Disease Control and Prevention. The grant is part of the CDC's new emphasis on encouraging HIV-positive people to protect their sex partners from the virus. More than $90 million in federal HIV prevention money is being diverted from traditional programs that encourage HIV-negative people to remain free from infection to prevention-for-positives programs. "Despite extensive preventive efforts targeted at people not infected with HIV, 40,000 new HIV cases are identified in the U.S. annually, a number that has remained somewhat consistent," Evelyn Byrd Quinlivan, an assistant professor of medicine at UNC and the clinic's medical director, told Health and Medicine Week.
The North Carolina clinic treats about 1,500 HIV-positive people each year. Clinic physicians during routine care appointments will now also assess their patients for any risky behaviors and reinforce safer-sex and safe injection-drug-use practices to encourage them to keep from spreading the virus. Patients also will be urged to reveal their serostatus to their sex partners. For clinic patients who do not know how to use condoms or do not feel comfortable revealing their status to their partners, a specially trained counselor will be on staff to address these issues.
To gauge the effectiveness of the program, patients will be surveyed several times during the coming months to measure the degree to which they self-report risky behaviors. The physicians also will report any new sexually transmitted disease infections, which are spread through unprotected sex. Clinic officials say they hope that if their program is ultimately shown to help reduce risky practices by their patients, it will be adopted as a national model for prevention-for-positives efforts.