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Rockefeller College of Public Affairs and Policy

UAlbany and Weill Cornell Researchers Discuss Broad Impact of HIV-Testing Guideline Changes in New England Journal of Medicine

ALBANY, N.Y. (February 21, 2013) -- University at Albany and Weill Cornell Medical College researchers discuss proposed changes in HIV-Testing guidelines by the U.S. Preventive Services Task Force (USPSTF) in a perspective article in the March 7 issue of the New England Journal of Medicine. Authors Erika G. Martin, assistant professor of public administration and policy at UAlbany’s Rockefeller College and fellow at the Rockefeller Institute of Government, and Dr. Bruce R. Schackman, associate professor of public health and chief of the Division of Health Policy at Weill Cornell, address the broad impact the changes will have on the health care of HIV-infected patients.

Updating the HIV-Testing Guidelines — A Modest Change with Major Consequences,” argues that changes to proposed guidelines -- including assigning a grade A recommendation to screening for HIV in the general population 15 to 65 years of age – will have significant implications for the way HIV testing is financed, largely due to the implementation of the Affordable Care Act. If the grade A recommendation is adopted, most individuals of this age who have public or private health insurance coverage will be able to receive an HIV test without any out-of-pocket cost.

UAlbany's Professor Erika Martin
UAlbany's Professor Erika Martin. (Photo by Mark Schmidt)

Martin and Schackman also point out that the cost of HIV testing is the “tip of the iceberg,” because most HIV costs are for treatment after diagnosis. Despite expanded insurance availability as a result of the Affordable Care Act, major reductions in safety net funding “would make it difficult to support HIV-infected patients who cannot successfully navigate the new environment or afford subsidized insurance with sufficiently generous benefits to cover their care.” The expected shift of funding from safety-net hospitals to community health centers may also reduce capacity at HIV clinics serving low-income patients, according to the authors.

“Improving insurance coverage for HIV testing is a critical step for identifying the one-fifth of people living with HIV who are unaware of their infection,” said Martin.

“Removing these financial barriers is a significant step, but anyone who is identified as HIV-infected must also be linked to and retained in care in order to improve their health and prevent further HIV transmission” said Schackman.

Read the full perspective from the New England Journal of Medicine. Read a transcript of Martin discussing the roles of the various organizations involved in making recommendations related to preventive medicine and public health, and the impact of national health reform on HIV testing.

About Weill Cornell Medical College
Weill Cornell Medical College, Cornell University's medical school located in New York City, is committed to excellence in research, teaching, patient care and the advancement of the art and science of medicine, locally, nationally and globally. Physicians and scientists of Weill Cornell Medical College are engaged in cutting-edge research from bench to bedside, aimed at unlocking mysteries of the human body in health and sickness and toward developing new treatments and prevention strategies. Weill Cornell is the birthplace of many medical advances -- including the development of the Pap test for cervical cancer, the synthesis of penicillin, and the first clinical trial of gene therapy for Parkinson's disease. For more information, visit
weill.cornell.edu.