At one Department of Motor Vehicles office in the nation's capital, motorists can get a driver's license, temporary tags and something wholly unrelated to the road: a free HIV test.
In a city with one of the highest percentages of residents living with HIV or AIDS, health officials have spent the past year test-driving the HIV screening program. Since the program began, more than 5,000 people have been tested at the DMV site and gotten results while they waited.
Now, officials are expanding the program, offering testing for the first time at a the Department of Human Services Anacostia Service Center at 2100 Martin Luther King Jr. Ave. SE, where Washington residents register for food stamps, Medicaid and other government assistance. On Monday, the first day of the program, 60 people got tested, officials said. As an incentive, they're being offered a $5 gift card to a local grocery store.
“This is the first project in the nation to offer free HIV testing at a government social services center,” Mayor Vincent Gray said. “While District residents are seeking income support, food stamps, Medicaid and other benefits, residents will now be able to learn their HIV status as a routine part of their health and wellness.”
“You have to meet people where they are,” explained Sheila Brockington, who oversees HIV testing at the DMV office in southeast Washington, the only one of the city's three DMV service centers where it is offered. “You're waiting anyway. You might as well.”
The testing project isn't run by the DMV but by a nonprofit group, Family and Medical Counseling Service Inc., which uses an office inside the site. To ensure confidentiality, residents get tested and receive results in the private office, out of earshot of those going about their usual DMV business. The nonprofit got a $250,000 grant to do the testing and secured the support of the city's Health Department and the DMV. Now a second, similar grant is funding the expansion.
Government statistics released in June show about 1.1 million Americans were living with the AIDS virus in 2008, and other studies show that about 10 percent to 20 percent of U.S. adults are tested annually. But those involved in HIV/AIDS work recognize that more needs to be done to identify people living with HIV, said Chris Collins, the vice president and director of public policy for amfAR, the Foundation for AIDS Research.
“We need to be looking for creative ways to reach people who haven't tested in the past,” said Collins, who hasn't studied Washington's program but said innovation and creativity by cities is important.
“This program seeks to create awareness and demonstrate the ease of HIV/AIDS testing by offering testing services in a non-traditional setting,” Department of Health Director Dr. Mohammad Akhter. “When people know their HIV status, they are more likely to take steps to take care of themselves and prevent the spread of HIV.”
In Washington, not everyone was sold on the idea when it was proposed by the head of the Family and Medical Counseling Service, Angela Wood. She came up with the idea after sitting at a DMV office herself. Initially, some officials doubted many people would test. Now, however, between 25 and 35 people get tested every day at the DMV location. Anyone who agrees gets $7 off their DMV services.
For those who test positive, the nonprofit offers a free ride to its nearby office where they can arrange counseling and an appointment with a doctor. So far, less than 1 percent of those screened have tested positive, though some already knew their status. That's below the city's infection rate of 3 percent.
By now, the four people who run the program at the DMV office have their pitch for testing down. When people are on line, one of the testers approaches with the offer: free tests, money off your bill, and the promise that it won't hurt.
“We don't do blood. We do swabs,” tester Karen Johnson tells patrons, explaining that the test of their saliva takes 20 minutes and that participants will not lose their place in the DMV line.
For patrons, the offer is generally a surprise, but not an unwelcome one.
Bus driver Nat Jordan, 35, was at the DMV office one day to get his car registered. He said he accepted because he gets tested once a year anyway. Colleen Russell, 28, a newly married nurse who was at the DMV to change her name on her driver's license, said she knew she was negative. But she said she got tested because she comes in contact with patients every day who could be infected.
Not all residents are sure of their status, though. One man who got tested and spoke on the condition that his name not be used said his wife is HIV positive. Though he had had a negative HIV test before, it reassured him to have a second one at the DMV.
Wood, the person who proposed the unconventional testing sites, said she understands they aren't right for everyone. That's fine, she said. The message: “It's important for you to take the test, whether you take it here or at another site.”