This HIV screening starts in the privacy of your own home

by Military Health System Communications Office
The Air Force offers self-collection kits that include instructions, supplies to obtain a finger-prick blood sample, and a prepaid envelope to mail the sample to a lab for HIV testing. — Photo courtesy of Military Health System Communications Office

The Air Force has developed a self-collection blood kit to encourage its active-duty members with a higher risk of acquiring human immunodeficiency virus to test for infection more frequently than what’s mandated by the military. The kits enable users to be proactive about their own health and potentially prevent the spread of HIV, which can lead to many health complications, including AIDS.

“Generally, HIV infection rates in the military are lower than in the general population,” said U.S. Air Force Lt. Col. Jason Okulicz, a physician and director of the HIV Medical Evaluation Unit, Infectious Disease Service, at San Antonio Military Medical Center.

“But every year, we have several hundred active-duty members in the Military Health System who are newly diagnosed with HIV infection,” he said.

Currently, all service members are screened for HIV every two years, before and after deployments, and when it’s clinically indicated by health care providers, based on symptoms or answers to routine questions about sexual partners and practices. However, the Centers for Disease Control and Prevention recommends that individuals most at risk of acquiring the infection get tested at least annually.

HIV can be detected in the blood as soon as a week after exposure, Okulicz said. About 40 percent of all new HIV transmissions in the United States are from people who are unaware they have the infection, said Okulicz, who’s also chair and Air Force lead of the TriService HIV Working Group. The group’s mission is to improve HIV care and prevention in the MHS.

Okulicz said the primary means of HIV infection among service members is sexual contact. “Because of perceived stigma, service members at high risk for HIV may not be willing to talk with their primary-care providers about getting tested more frequently,” Okulicz said. “The kits provide a way to lower this possible barrier to testing.”

Active-duty Air Force members can request a kit be mailed to them by calling 210-916-5554 (DSN 429) or emailing IDVirtualHealth@mail.mil. Each kit includes instructions, supplies to obtain a blood sample via a finger prick, and a prepaid envelope for returning the sample to the HIV Diagnostics and Reference Laboratory at the Walter Reed Army Institute of Research in Silver Spring, Maryland.

Those who have negative results – meaning that they don’t have HIV – receive a phone call from the HIV Medical Evaluation Unit office with the news, along with an explanation of what the test means.

“For example, if you had high-risk sexual activity a few days before you took the test, it may be too soon to know if you acquired HIV,” Okulicz said. The MEU office can also answer any questions and offer information about reducing future risk of infection.

For those who’ve tested positive for HIV, in-person notifications are arranged at the local base level. “People may have an adverse reaction because they’re worried not only about their health but also their career,” Okulicz said. “We want to make sure they have the support and information they need.”

There’s an established protocol for service members who test positive for HIV, Okulicz said. Generally, those who test positive can remain in uniform as long as they’re capable of performing their military duties.

Okulicz said the kits augment mandatory screening and are not alternatives or replacements. He said because there isn’t a good process in place to ensure face-to-face communication with reserve component members or dependents, the kits are available only to active duty Air Force members.

“My counterparts in the other services are aware of and interested in our initiative, but next steps haven’t yet been developed,” Okulicz said, referring to colleagues in Army Medical Command and the Bureau of Naval Medicine. He said the Air Force is in discussions on how the initiative could be rolled out across the DOD.