Online Toolkit Helps Providers Maximize
The Health Research & Educational Trust
developed a free online toolkit to assist
hospitals, physicians and clinics in calculating
their costs and reimbursement for HIV testing
and screening. The package includes a cost
calculator and a summary of key issues and
resources to consider when starting or expanding
an HIV testing program.
Access the toolkit at www.hret.org/hiv-cost.
For more information, contact Joan Miller at firstname.lastname@example.org
HIV Testing CPT Coding Guide Developed by AAHIVM
The American Academy of HIV Medicine and the
American Medical Association, along with
contributions from other organizations, recently
updated an HIV Testing CPT Coding Guide used for
reporting of outpatient services. Because
hospitals use these codes for any type of
outpatient services for all payers, using them
fits in with hospitals’ goals to prevent
perinatal HIV transmission
To view the guide, click here.
Issues Resources on Health Reform and
The Kaiser Family Foundation released a new
narrated-slide tutorial and an updated issue brief that examine the
implications of the new health reform law for
women and their health and health care. The
resources feature information on HIV testing and
In the KaiserEDU.org tutorial Health Reform: Impact on Women’s
Health Coverage and Access to Care, vice
president, Kaiser Family Foundation and director
of the Women’s Health Policy project, Alina
Salganicoff, Ph.D., reviews how the Patient
Protection and Affordable Care Act is expected
to impact access to care and affordability of
health coverage for women.
The tutorial also explains the provisions in
the new law related to preventive screening
services, reproductive health, maternity care
and women on Medicare. Much of the same ground
is covered in greater detail in the updated
issue brief Impact of Health Reform On Women’s
Access to Coverage and Care which includes
national and state-level estimates of the
percentage of uninsured women ages 18-64 who are
likely to qualify for federal help under the law
and a summary of key coverage and benefits
provisions in the law that affect women.
The foundation also updated two fact sheets
on women’s health insurance coverage, reflecting
the latest data from the U.S. Census Bureau. One
fact sheet, revised to reflect
major issues in health reform implementation,
provides statistics on health coverage and
describes the major sources of health insurance
for women ages 18-64. The other provides detailed
state-level coverage information for the 50
states and the District of Columbia.
Streamlines HIV Consent and Testing
The state of Michigan passed a new law (PA
320 of 2010) that allow providers to incorporate
consent for HIV testing into the general consent
for medical care, and provide pre-test
information verbally beginning January 1, 2011.
The new legislation circumvents previous
requirements to provide separate, written
This legislation is in line with the national
trend to normalize HIV testing by incorporating
it into other routine care.
For more information, see this memo to health providers or go
to the Michigan Department of Community Health
website at http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982---,00.html.
Extends OraQuick Rapid HIV Test Shelf Life
OraSure Technologies announced that U.S.
regulators approved extending the shelf life of
the OraQuick ADVANCE Rapid HIV-1/2 Antibody Test
test to 24 months, up from 18 months.
Manufacturing improvements in the product
resulted in its longer shelf life, said OraSure
officials. Using oral fluid or blood samples,
the OraQuick HIV test yields results in about 20
minutes. OraSure now is seeking Food and Drug
Administration approval for over-the-counter
sales of OraQuick, which currently is used in
clinics and hospitals.
For more information, go to http://www.orasure.com/.
Women With HIV Develop Worse Outcomes Than Men
Women with HIV had worse outcomes than men,
despite favorable clinical parameters on
enrollment, according to a 1997-2007 study of
recently and acutely infected patients,
published in the Journal of Infectious Diseases.
The study was based on 2,277 HIV seroconverters,
including 124 women, enrolled in the Acute
Infection and Early Disease Research
Among the study findings:
- Initially, women averaged .40 log10 fewer
copies/mL of HIV-1 RNA (P<.001) and 66 more
CD4+ T cells/µL (P=.006) than men, after
controlling for age and race.
- Nonwhite men and women were less likely to
initiate antiretroviral therapy (ART) at any
time than white men (P<.005).
- Patients in the US South were less likely to
initiate ART compared with those in other
- Women were 2.17-fold more likely than men to
experience at least one HIV/AIDS-related illness
(P<.001), and nonwhite women were most likely
compared to all others (P<.035), adjusting
for IV drug use and ART.
- Eight years after diagnosis, 78 percent of
nonwhite and 37 percent of white patients in the
South had reported at least one HIV/AIDS-related
illness, compared with 24 percent of whites and
17 percent of nonwhites from other regions
The full study, "Sex, Race, and Geographic
Region Influence Clinical Outcomes Following
Primary HIV-1 Infection," was published in the Journal of
Infectious Diseases (2011;203(4):442-451).
The December 2010 issue of Clinics in
Perinatology entitled “Perinatal HIV Infection”
is a comprehensive review of the biology,
epidemiology, and prevention of perinatal HIV
transmission, as well as the clinical care and
optimal management of the pregnant mother and
her exposed or infected infant.
The 12 articles cover such topics as
antiretroviral drug strategies, Cesaerean
section, breastfeeding, postnatal HIV
transmission prevention and care of HIV-infected
infants, among others.
To access the journal, go here http://www.perinatology.theclinics.com/current
Breast Milk Continues, Despite Government
Warning of HIV Risk
For the first time, Food and Drug
Administration advisers met in December to
collect information and seek public comment on
formal human-milk banking. Though casual milk
sharing among mothers was not on the meeting
agenda, it is a concern to FDA, according to the
The FDA warned "against feeding your
baby breast milk acquired directly from
individuals or through the Internet" due to the
risk of infectious diseases like HIV and
contaminants, including illegal drugs.
According FDA data, the chances of
transmitting hepatitis B or C through breast
milk are "negligible." However, there is a 42
percent risk of transmitting HIV and a 76
percent chance of passing along cytomegalovirus.
"Flash pasteurization" - heating milk at 144
degrees Fahrenheit (62 degrees Celsius) for 30
minutes - kills most germs.
Explores Influences of Unintended Pregnancy on
Unintended pregnancy is commonly used as a
proxy measure for reproductive control, a
concept that refers to an individual's ability
to control his or her own reproduction,
according to an article in Sexual Health.
In the study, the researchers used unintended
pregnancy as a proxy measure for reproductive
control by analyzing data on 4,521
heterosexually active female participants in the
National Survey of Family Growth, Cycle 6.
Self-reported pregnancy intention was used to
group women into four categories: women
reporting one unintended pregnancy; women
reporting two or more unintended pregnancies;
women reporting intentionally having no
pregnancies; and women reporting that all their
pregnancies were intentional (reference
category). Polytomous logistic regression,
weighted for the complex sampling design,
provided estimates of odds ratios (OR) and 95
percent confidence intervals (CI).
The results showed that 51 percent of women
who reported one unintentional pregnancy went on
to report at least one more such pregnancy. The
following were found to significantly predict
multiple unintended pregnancies: being black,
Hispanic, born to a mother younger than 18 at
first birth, having multiple partners, and age
of first sexual debut (consensual or
Relative to those reporting sexual debut
after age 18, women who reported sexual debut
before age 15 were at increased risk of multiple
unintended pregnancies (adjusted OR, reported as
consensual: 6.96; 95 percent CI: 4.26 to 11.39)
(adjusted OR, reported as non-consensual: 27.10;
95 percent CI: 11.03-66.57).
"Efforts to delay sexual debut and to protect
girls from non-consensual sex are sorely needed
to prevent a lifelong trajectory of lack of
reproductive control," the authors concluded.