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Grady Hospital just started a routine testing program for HIV patients in 2013, and already, Atlanta is ranked number 1 in U.S. cities for its rate of new diagnoses of HIV.

The problem is that HIV testing is not routinely available where most people go for health care. And even though Grady is the only emergency department in Atlanta to offer the program, there are 50 other places people can go to get tested.

“Despite that, there are patients who aren’t going to get those tests. And they aren’t going for a decade,” said Dr. Abigail Hankin-Wei to WABE.

These patients who go undiagnosed can and often will develop AIDS, despite the fact that it takes 8 to 10 years for HIV to develop into AIDS when it is untreated. By the time patients in Atlanta are diagnosed, one third will have advanced to clinical AIDS.

“When we diagnose patients with HIV, the first time we are telling them they’ve been infected with HIV, we know that among our patients at Grady, nearly half of them have AIDS the day we diagnose them,” said Hankin-Wei.

There are many reasons people may not get tested, ranging anywhere from poverty, fear, the stigma of the disease, or even the fact that those in a monogamous relationship feel safe. But testing and treatment can significantly decrease the risk of transmission … to almost nothing.

“Diagnosing people to get people on treatment is our best method to prevent further transmission,” said Wendy Armstrong, the director of the Ponce de Leon Center, an AIDS care facility in Atlanta.

Catherine Hanssens with the Center for HIV Law and Policy in New York noted that testing should ideally take place long before an emergency room visit: “Frankly if someone is in a medical emergency or they present with a gunshot wound or a knife wound that is probably the very worst and last time that you would ever offer an HIV test.”

But in the meantime, Grady will continue to offer the testing and push for Georgia to do better.