Adolescent AIDS Program: ACTS


Gilead Sciences is a proud sponsor of ACTS

For more information
about ACTS, contact
Stephen Stafford at
sstafford@adolescentaids.org
or 718-882-0232, ext. 227

New York State Requires Health Care Providers to Offer HIV Testing to All Patients ages 13-64.

On July 30, 2010, Governor David Patterson signed a bill into law that finally makes HIV testing a routine part of health care for New Yorkers. The law, which goes into effect on September 1, 2010, will:
 

  • Require that an HIV-related test be offered to every individual between the ages of 13-64 who receives health services in any health setting including hospitals, emergency rooms, hospital outpatient departments, and primary care settings;

  • Allow patients to give oral consent for a rapid HIV test and blanket consent for HIV testing as part of their durable medical consent. In the past, all HIV tests required patients to provide a separate written consent;

  • Permit anonymous testing of the blood of a person who is deceased, comatose or otherwise lacks the ability to consent, if someone such as a health care worker is exposed to the person’s blood.

 
“We applaud the members of the New York State Legislature. By requiring the offer of an HIV test, this bill represents a giant step forward in eliminating longstanding barriers to testing and ensuring that more New Yorkers, especially African-Americans and other communities of color, will know their status and gain access to early treatment and care if needed” 

C. Virginia Fields
President and CEO of the National Black Leadership Commission on AIDS
 

“While this legislation falls short of a true opt-out approach to HIV screening in New York, we are confident that it will advance our efforts to make HIV screening a routine part of care, most particularly with a required offer of an HIV-related test in all health care settings. We strongly believe that the required offering is a necessary corrective to 25 years of segregated HIV testing - segregated in the sense that a legacy of counseling and testing regulations make HIV testing someone else's responsibility in health care.”
 

Patrick J. McGovern,
CEO of Harlem United: Community AIDS Center

What is ACTS?
ACTS (Advise, Consent, Test, Support) is an innovative approach to HIV counseling and testing that is proven to facilitate significant improvements in HIV testing in both clinical and community-based settings. The ACTS approach includes a field-tested 4-step system for transforming HIV testing including: Obtaining Buy-in, Implementation Planning, Training and Monitoring/Evaluation. ACTS also features a streamlined HIV “counseling” approach that can be delivered in as few as two minutes so that providers can feasibly integrate HIV testing into routinely delivered care. Download the ACTS Pocket Card from our online toolkit to see how you can Advise, Consent, Test and Support  in a matter of minutes.

Making HIV testing more routine is important because HIV positive people who learn their status can access treatment that improves their health and prolongs their lives. Plus, they are more likely to prevent transmission to others as antiretroviral treatment lowers viral load and half report reducing their high-risk sexual behaviors once they know they are infected.

In line with the CDC’s recommendation to routinize HIV testing in clinical settings, ACTS is a model for anyone in health care who strives to achieve a paradigm shift from the limitations of conventional HIV testing.

Developed by the Adolescent AIDS Program at Montefiore Medical Center in the Bronx, with funding support from the New York/New Jersey AIDS Education and Training Center, ACTS is now implemented throughout the United States and South Africa. Notably, ACTS is being used by clinical and community partners in the largest municipal scale up of routine HIV testing in the US: The Bronx Knows HIV testing initiative sponsored by the New York City Department of Health and Mental Hygiene and a coalition of Bronx community partners. It is also being used in other municipal scale ups of testing in Oakland and Miami. In South Africa, the entire Western Cape Province is implementing ACTS in all 420 of its public health facilities. For more information, visit ACTSHIVTest.org.za

FAQs
Is there a cost to use ACTS?
There is no cost to use ACTS with the downloadable resources found on this Web site. Please acknowledge ACTS using our logo and website address on all materials you use/adapt.

Where can ACTS be used?
ACTS is designed to be adaptable for any clinical or non-clinical setting where HIV testing can be offered. ACTS is being successfully implemented in community clinics, emergency rooms, hospital in-patient wards, school-based clinics, community-based organizations and youth-serving venues.

How long does it take to see results?
Several factors influence how fast you can scale up routine testing. The ACTS system is field tested to address the four critical steps to success: Buy-in, Implementation Planning, Training and Monitoring/Evaluation. Once the first three steps have been successfully completed, results can be seen immediately but it takes sustained support from management and staff champions to achieve real success. In a randomized trial of ACTS in 10 community based health clinics in the Bronx, New York, the five ACTS clinics increased testing by 133% within a year. In the Tygerberg sub-district of Cape Town, South Africa, the clinics achieved a doubling of the proportion of adult population tested using ACTS in less than a year.

If I use ACTS am I required to provide reports?
You will not be required to provide information about your clinic or organization’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 discuss how ACTS is working for you. For your own monitoring and evaluation purposes, we recommend that you utilize your site’s existing data sources to assess testing numbers and rates before and after ACTS to assess progress.

Do I have to order clinic packs or can I just get individual lots of ACTS materials?
You can order pre-printed materials separately or in packs, though there are minimum order requirements. You can also work with us to localize materials to suit your specific needs. Contact us to discuss options.

If you have a question you would like answered, please contact sstafford@adolescentaids.org

ACTS Toolkit
This collection of materials and tools is designed to familiarize providers, administrators, trainers and other clinical and non-medical staff with ACTS. These online materials may be downloaded for individual sites' use but may not be sold or adapted for mass distribution.

ACTS Training Slides (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

Click below if you would like to order professionally printed materials tailored to your needs.

Presentations and Resources
ACTS Presentation at 2010 International AIDS Conference (South Africa Project)

ACTS Presentation at 2008 International AIDS Conference (US Project)

Taking Charge of the HIV Epidemic: 2010 National HIV Testing Day Webcast
Bernard Branson, MD, Brad Ogilvie, MS, Gerald Shochetman, PhD, Veronica Miller, PhD (moderator)

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