Starting Tuesday, getting tested for HIV in the District will be as easy as renewing a driver's license. In what District officials say is the first effort of its kind nationwide, the city will partner with a nonprofit to offer free HIV testing at the Department of Motor of Vehicles in Penn Branch - with participants receiving up to $15 to help defray DMV costs.

 The year-long project would be another way to reach residents in a city where a 2008 epidemiology update concluded 3 percent of the population had tested positive for HIV/AIDS. That is well above the 1 percent considered to be a general epidemic, advocates for prevention and city officials said.

"We wanted to have a broad audience and a captive audience. You're captive at the DMV," said Angela Fulwood Wood, chief operations officer of Family and Medical Counseling Service, a Southeast nonprofit group that already tests about 5,000 District residents a year.
But the program takes two other unusual steps: It offers up to $15 to help offset the costs of DMV services and provides immediate counseling as well as medical attention. Based on traffic at the Penn Branch DMV and human behavior in other free testing programs, organizers expect to test about 3,000 people annually, roughly 15 percent of the customers at the DMV location. Rapid oral test results at the DMV office will be available in 20 minutes.

The goal, however, goes beyond testing. "We're normalizing people's thoughts of testing," Wood said. "You can do organ donation at the DMV. You can do voter registration at the DMV. If people don't want to do it, we can at least talk to them."
City officials chose the Penn Branch DMV, which is in Ward 7, to ensure the program reaches residents in wards 7 and 8, where HIV infection has risen, Wood said.

"This is exactly the kind of innovation we need in this city," said D.C. Council member David A. Catania (I-At Large),who called Wood a "rock star" for coming up with the unorthodox idea. "This is a model for the country in how we bring testing to people on a routine basis."
A. Toni Young, executive director of Community Education Group, said the program will reach residents who do not visit doctors regularly and are apprehensive about going to clinics and testing sites. Going to the DMV jumps the hurdle of "waiting for people to come in and ask for the test," said Young. "We see people we may miss through the medical system."

Those who test positive will get counseling at the DMV and more extensive, one-on-one services at CEG's office nearby. "I'm not going to give you a slip of paper and say the onus is on you, now go" get help, Young said. "We will pick them up, take them to Family Medical and then back to the DMV. We will follow up with a call within 24 hours."

The city Health Department is supplying HIV testing kits and educational materials, and the DMV is contributing office space. Family and Medical received $250,000 in funding from Gilead Sciences, a Foster City, Calif.-based biopharmaceutical company, to help cover staff and the $15 money orders made out to the D.C. treasury for license renewals, changes in address and other services.

Gilead spokeswoman Cara Miller said in an e-mail the project is in keeping with the company's efforts to "normalize" testing in "traditional and non-traditional settings, and help empower local leaders to effectively communicate to their communities the value of knowing one's HIV status."
The program isn't Family and Medical's first attempt at incentive-based testing. In June, the group teamed up with IHOP in Southeast for National HIV Testing Day. The first 100 people tested received $10 coupons toward their meals at the restaurant.

But organizers acknowledge that the DMV, a crowded public place, could be intimidating for people already concerned about the stigma surrounding HIV/AIDS, which led to the estimate that 15 percent of customers would participate.

Council member Yvette M. Alexander (D-Ward 7) praised the DMV project as "awesome" but wondered whether those tested could choose to learn their status later after leaving the DMV if they are fearful of having an emotional outburst.

Wood said data show there's often a lag between testing, learning the results and getting medical attention, but that she would want those who test positive to get help immediately. "Everybody's not going to want to test at the DMV, but there will be people who say, 'I'm here, I'm waiting,' " Wood said. "They want to know their status."