I've never personally understood the rationale not to screen/test/diagnose in low resource settings and personally have never agreed with this stance. I serve marginalized (HIV community - most with Ryan White coverage, undocumented) and there are avenues to get follow up for these patients. Most states now allow RW programs to sign patients up for affordable care plans, hospitals offer financial assistance programs. Patient might even choose to move to a jurisdiction that offers coverage if they know they have a diagnosis - any of these options often takes more than six months but I would argue are better alternatives that letting disease go undiagnosed and untreated. Curious on any thoughts.

John Stanton, DNP, MPH, AGPCNP-BC, AAHIVS