Experience ACTS

More than 200 providers from across the country recently took part in a record-breaking teleconference on ACTS that drew more participants than any other training exchange sponsored by the AIDS Education and Training Centers’ National Resource Center. 

See for yourself how ACTS can make HIV testing a routine part of the care you deliver by accessing the online ACTS tutorial and materials found below. In less than 2 hours, you will understand the ACTS approach and how to put its easy-to-use tools to work in your practice. After you experience the tutorial, adapt the slide set as needed to train your staff or use as a TOT.

Step 1:
First, download the suite of ACTS materials you will need to review before, during and after the ACTS training presentation. Then download and read or listen to the ACTS training presentation.

Step 2:
If you would like to implement ACTS, click here for tools and resources.

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Frequently Asked Questions (FAQs)

Is there a cost to use ACTS? There is no cost to use ACTS with the downloadable resources. Please maintain the ACTS logo and website on all materials.

In which clinical settings is it appropriate to use ACTS? ACTS is designed to be adaptable so it can be used in any clinical setting. It is currently being implemented in community health, emergency room, in-patient, school-based, and youth clinical settings.

If I use ACTS am I required to provide reports? You will not be required to provide information about your clinic’s use of ACTS, but we welcome informal reports of your challenges and successes. Because we require you to give us contact information, we may contact you to check in on how ACTS is working for you. You may want to devise a simple system to assess testing numbers and rates before and after ACTS to assess your own progress.

Do I have to order clinic packs or can I just get individual lots of ACTS materials? You can order materials separately or in packs, though there are minimum order quantities. Contact us to discuss your clinic’s specific needs.

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If you have further questions or comments, please contact:

• Michelle Lyle, MPH
• Stephen Stafford
• Connie Ortiz

What is ACTS?
The Adolescent AIDS Program at Montefiore Medical Center in the Bronx, in collaboration with the New York/New Jersey AIDS Education and Training Center, has developed ACTS (Assess, Counsel, Test, Support), a paradigm-shifting approach to HIV Counseling and Testing (C&T) that is proven to help make C&T a more routine part of health care services in various health care settings.

For more than a decade the number of new HIV infections has remained steady at 40,000 each year. In primary care settings, many opportunities are missed to identify HIV+ patients and many of those infected are still unaware of their status and/or not linked to care.

• Monumental advances in HIV treatment have not yet spurred similar advances in case finding. An evolution in counseling and testing is needed to identify the estimated 300,000 people in the U.S. who are HIV+ but unaware of their infection or not linked to care. Early detection of HIV infection and linkage to care is advantageous for both the patient’s health and for the prevention of further HIV transmission.

• HIV counseling and testing has been separated from primary care, a development that has created barriers to successful case finding. Providers need to be engaged and empowered to take advantage of the opportunities they have with patients to test for HIV. ACTS addresses the philosophical and administrative barriers that can impede more routine screening for HIV among clinical populations.

• Because half of all new HIV infections are in young people, and because they are dangerously under screened by their health care providers for STDs including HIV, we are advocating for special attention to screening and testing this population.

• The availability of rapid HIV tests makes it timely to introduce a new paradigm that may include rapid pre-test counseling, same day testing or delivery of test results by phone.

• ACTS can serve as an adaptable scaffold for training and implementation of the full range of HIV testing approaches.

• The billing ramifications of practicing ACTS are advantageous. In some states, primary care visits that include ACTS can bill for a separate counseling and testing visit.

• Research shows the majority of providers aren’t offering HIV counseling and testing routinely to their at-risk patients because: they are not aware of their patients’ risk, they feel they do not have enough time to engage in traditional pre-test counseling, and they don’t think they are experienced enough in counseling to offer a patient an HIV test themselves. ACTS addresses all of these major barriers to provider-delivered C&T.

• A randomized trial of ACTS is currently underway in community health clinics in the Bronx, NY, where HIV testing is under utilized. Preliminary results after a year of implementation showed a doubling of testing among the intervention sites, and further progress is being monitored. Additionally, a CDC-sponsored trial of ACTS is also underway in two youth clinics in Cape Town, South Africa, where HIV testing at those sites has also doubled and the number of newly identified HIV-positive patients has doubled as well.

• Due to the success of ACTS in the Bronx community health clinics intervention sites, we are planning to expand implementation of ACTS to the control sites in September 2006.

Implementing ACTS
This package of materials and tools can help to familiarize providers, administrators, trainers and other clinic staff with ACTS, a proven new HIV counseling and testing approach that can make HIV screening a part of routine health care in various clinical settings.

ACTS Training
(Powerpoint Slide Format)

ACTS Training (PDF Format)

ACTS Manual (Cover)
ACTS Manual (part 1)
ACTS Manual (part 2)
ACTS Manual (part 3)
ACTS Manual (part 4)

Preparing Your Site for ACTS Checklist

ACTS Pocket Guide

ACTS English Brochure

ACTS Spanish Brochure

ACTS Newsletter

These online materials may be downloaded for individual sites' use but may not be sold or adapted for mass distribution. Click below if you would like to order professionally printed materials tailored to your needs.

References and Resources
Expanded Screening for HIV in the United States – An analysis of cost-effectiveness by Paltiel AD, Weinstein MC, Kimmel AD, et al.

Cost-effectiveness of screening for HIV in the Era of HAART by Sanders GD, Bayoumi AM, Sundaram V, et al.

Applying Public Health Principles to the HIV Epidemic by Frieden TR, Das-Douglas M, Kellerman SE, Henning KJ

Routine Screening for HIV Infection – Timely and Cost-effective by Bozzette SA

Is HIV/Sexually Transmitted Disease Prevention Counseling Effective? Compendium of States' HIV/AIDS Laws

Kaiser Family Foundation