A Gateway to Care: HIV Counseling, Testing, and Referral Services at ASC
(Released: 8 January 2007)

Each month, ASC’s CTR team provides at-risk men and women with HIV rapid testing, pre- and post-test counseling, and immediate linkages to treatment and care.
One in four HIV-positive New Yorkers have never been tested and are unaware of their status. Among those who do get tested, fully 25% first learned they were HIV-positive late in the process, many having already progressed to full-blown AIDS. To help more people learn their HIV status, ASC actively promotes its HIV counseling, testing, and referral (CTR) services, reaching out to underserved populations at risk, including substance users, immigrant populations, and the homeless. In the past year alone, the number of HIV tests ASC has performed has more than doubled.

The advent of rapid testing—yielding test results in under an hour—has helped significantly. In the past, people had to wait days or even weeks for their HIV test results. Unfortunately, many never returned to learn their status. At ASC, 100% of those testing HIV-positive are connected to specialized medical care the same day they get their test results.

But even before the results are in, a vital process called "pre-test counseling" is already underway. While awaiting the test result, ASC's trained CTR counselors meet with the client to discuss the implications of the test and help that individual begin to map a way forward, regardless of the outcome.

"Pre-test counseling is integral to the testing process," explains ASC Deputy Director of Planning Kim Atkins. "HIV testing raises such anxiety for most people that, once their results come back, they don't hear much of anything besides the words ‘you're positive' or ‘you're negative.' If they're HIV-negative, they're overcome with elation. If they're HIV-positive, they're overcome with apprehension. Those 30 or 40 minutes before the test results come back offer an incredibly useful opportunity to prepare people for their result and help them consider how to make the best use of the information, whatever their test result might be." One CTR client at ASC described her experience with pre-testing counseling as allowing her to be "emotionally prepared" for her result and "smarter about HIV."

HIV testing is a gateway to services that save lives. ASC provides information and care that help people reduce the risk of re-infection, protect their partners, adhere to their treatment regimen, and cope with the avalanche of emotional, practical, and disclosure-related issues that newly diagnosed individuals often face. For those who test negative, ASC helps them stay negative, through harm reduction programs, safer sex workshops, substance abuse counseling, and access to other health services they may need, including TB testing, substance abuse treatment, and STD screening.

ASC's CTR Coordinator Stacey Keith spells out the program's prescription for success. "Rapid testing at ASC ensures that every person tested receives his or her test result and is connected with the medical and HIV prevention services they need to stay healthy and protect others. We maintain a caring, nonjudgmental environment that supports people every step of the way."

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