Tomorrow is World AIDS Day, and this year’s theme is “Working Together for an AIDS-Free Generation.”

According to the CDC, approximately 1.1 million U.S. residents are living with the human immunodeficiency virus (HIV), and roughly 20 percent of them don’t know they have it. CDC statistics show that African Americans are the most acutely affected racial group due to social and economic challenges like lack of access to care, discrimination, homophobia and poverty. Latinos also are a disproportionately affected population.

Although prevention efforts recently have helped stabilize the rate of new infections – about 50,000 people become newly infected each year – an increase in the number of people living with HIV could lead to more infections without proper care and treatment.

NAPH member hospitals nationwide are finding innovative ways to not only increase screening and awareness of HIV, but also to provide comprehensive treatment for HIV-positive patients. For example, Arizona-based Maricopa Medical Center, part of Maricopa Integrated Health System (MIHS), has implemented the Test AZ program, becoming the first hospital in the state to adopt routine, opt-out HIV/AIDS rapid testing in the emergency department (ED).

Although Maricopa Medical Center in 2005 implemented rapid HIV testing in its labor and delivery department, it wasn’t until the CDC awarded a grant to the Arizona Department of Health Services in October 2010 that such testing expanded to the ED through the Test AZ project.

Specifically, Maricopa Medical Center through the program offers HIV testing to all patients aged 18 to 64 who present to the adult ED and are able to consent for testing. Triage nurses provide patients an informed consent brochure and note in the patient’s medical record that he or she received informed consent and accepted or declined HIV testing.

The ED then conducts the test and sends it to the lab according to HIV testing protocol. If the test is negative, the result is documented in the patient’s chart. If the test is positive, the result is documented in the patient’s chart and reported to the Office of Public Health. The patient then is connected to a “Linkage to Care Specialist,” who puts him or her in touch with case management, medical care and other support services.

According to Maricopa staff, the program has been extremely successful so far. From July 2011 to October 2012, the hospital identified 34 patients who tested positive for HIV, which equates to a positivity rate of 0.3 percent. The CDC recommends that health care providers routinely offer HIV screening to their patients if the diagnostic rate is greater than 0.1 percent.

“The sooner the patients know their HIV status, the sooner they can change their behavior,” said Cheri Tomlinson, Test AZ’s grant director. “We estimate that we have averted eight infections by identifying the 34 people.” In addition, Maricopa notes that the program has identified more than $5 million in medical cost savings.

For Maricopa, the Test AZ program has been about more than just HIV prevention. “Traditionally the ED has not been a source of public health. This program is opening up the possibilities to reduce return visits to the ED and improve the overall health of the community,” said Brenda Sutton, RN, MSN, MBA, director of emergency services at MIHS.

Comprehensive screening and treatment programs like the one at MIHS are key to fulfilling this year’s World AIDS Day theme of “Working Together for an AIDS-Free Generation.” The MIHS program not only helps people know their HIV status – thereby reducing the risk of transmission – but also underscores the effectiveness of a multidisciplinary, team-based approach to HIV/AIDS care.

To learn more about Test AZ – or to access the tools and resources Maricopa used to implement the program – please visit

To learn more about HIV/AIDS on World AIDS Day, follow the Twitter hashtag #WAD2012, or visit