Policy Changes Not Sufficient

She and her colleagues recognized, however, that the policy changes alone would not necessarily change practice when it came to screening. “Our office has had numerous interventions over the last year to initiate culture change — not only among veterans, but also among providers,” says Czarnogorski.

For example, a clinical reminder was developed in the electronic medical record used by providers who treat veterans. It prompts the primary-care provider to conduct screening for any veteran who had been screened previously. “It’s automatic, appearing as you go through a routine medical exam,” Czarnogorski explains.

In addition, she continues, VA has supported numerous grants in the field to develop best practices and tools to promote testing in various settings — mental health, women’s health, homeless veterans and facilities of various sizes and types (i.e., rural, urban.) “We supported 10 grants alone for materials this year on women’s health,” she shares.

Another intervention has involved “stand-downs” – health fairs for homeless veterans around the country – which occur once or twice a year. The evening events provide services such as enrollment and routine medical screenings. 

“We also funded numerous sites to do rapid HIV testing,” says Czarnogorski. The oral swab results, she notes, are ready in 20 minutes, which helps deliver results to a population that may be marginally housed.

VA also declared “HIV Testing Week" this year to coincide with June 27, National HIV Testing Day. The weeklong event, which also included HIV testing, was designed to “generate more enthusiasm” for screening, Czarnogorski explains. 

Finally, she continues, VA has launched a sizable social marketing campaign that targets providers and veterans. It includes videos, brochures, and posters to promote the new policy to providers and encouraging veterans to request HIV testing. The “Get Checked” campaign, says Czarnogorski, will mainly target VA facilities.