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Institute of Medicine Outlines HIV Care Capacity

More HIV services will be needed for people identified as HIV positive through stepped-up screening, according to the Institute of Medicine.

The Institute of Medicine (IOM), the health arm of the National Academy of Sciences, released a report last week -- entitled HIV Screening and Access to Care: Health Care System Capacity for Increased HIV Testing and Provision of Care -- which estimates what kind of services will be need as more people test positive for HIV due to increased screening efforts mandated by the federal government.

"More than 200,000 people living with HIV/AIDS in the United States do not know they are infected," according to the IOM. "Increased HIV testing may help identify these individuals, reducing the chance that they will spread HIV to others and improving their health outcomes."

However, as the report describes, there is a widening shortfall of providers offering HIV services and funding to support them. The IOM estimates that each person newly diagnosed with HIV needs counseling, referrals, treatment, and monitoring estimated to cost more than $19,000 per year, on average.

Jeff Crowley

"The report finds that budget constraints at state and local health departments pose a barrier to more widespread HIV testing," Jeffrey Crowley, director of the Office of National AIDS Policy -- which commissioned the IOM report -- wrote on the ONAP and blogs. "In addition, fewer practitioners are specializing in HIV/AIDS care and the number of specialists entering the workforce is not replacing the number retiring."

For example, the report notes, 45% of the members of the HIV Medicine Association (mainly physicians) are age 50 or older, and nearly 60% of the members of the Association of Nurses in AIDS Care are between age 40 and 50.

The report suggests several steps to help fill these gaps, including more training in HIV/AIDS treatment and care and sufficient funding to support screening efforts.

The National HIV/AIDS Strategy for the United States, released last summer, recognizes the importance of ensuring that all people living with HIV know their status and are well supported in a regular system of care, while the Affordable Care Act (health insurance reform) includes provisions to expand and better support the health care workforce, Crowley added.

Download or read the full report for free at

Read Crowley's compete blog entry at



Institute of Medicine. "HIV screening and access to care: health care: system capacity for increased HIV testing and provision of care." National Academies Press. March 17, 2011.

J Crowley. Institute of Medicine Releases Report on Health Care System Capacity for Increased HIV Testing and Provision of Care. March 21, 2011.