City health officials have set an ambitious goal of testing a quarter million adults in the Bronx for HIV within three years.

Under a new program announced Thursday, the city is hoping to persuade doctors to offer the tests to nearly every patient — a step some have avoided in the past as an unnecessary hassle.

"We need every single individual to know their status," said Dr. Monica Sweeney, an assistant health commissioner who specializes in HIV prevention.

Like dozens of other states, New York now requires doctors to obtain a patient's written consent and provide a brief counseling session before giving them an HIV test.

The process can take up to 20 minutes — a substantial enough time, according to the city, to deter doctors and nurses from suggesting HIV tests to patients routinely.

Now officials want health clinics to offer the tests to anyone who seeks care, even for something as simple as a broken wrist.

For now, the campaign centers on the Bronx, a community hit harder than most by AIDS.

HIV testing in the borough is already fairly widespread. Nearly 7 of 10 Bronx adults have been tested at least once in their lifetime.

But as many as 250,000 adults in the borough have never been tested, and statistics indicate that many are diagnosed far too late.

More than a quarter of the 829 people who tested positive in the Bronx in 2006 already had developed AIDS, the city said, meaning they'd probably carried the virus for a decade without knowing it. The late diagnosis also made their long-term prospects grim.

Federal health officials recommended routine HIV testing for all Americans ages 13 to 64 nearly two years go, but the effort has stalled. Some doctors have questioned whether so much testing is necessary, or worth the bureaucratic cost.

Dr. Donna Futterman, director of the adolescent AIDS program at Montefiore Medical Center, said part of the Bronx campaign will be aimed at assuring medical providers that routine testing has real benefits.

"This would make an absolute, numerical dent in the number of new cases," she said.

The city is also telling doctors that the state-mandated HIV consent procedure doesn't have to be so onerous, if managed properly. The counseling sessions, Futterman said, can be shortened to a few minutes for patients who don't want the whole thing.

Forty health care clinics have agreed to join the program so far, with more expected to follow suit.

City health officials have also urged changes in state law that would do away with both the written consent form and the mandated counseling sessions, arguing that they have little benefit.
Those changes have been opposed by some AIDS activists who say they don't see the counseling requirement, or the paperwork, as a barrier.

"We find that period of time extremely useful," said Marjorie Hill, chief executive officer of the Gay Men's Health Crisis. She said it gives doctors a time to talk with patients about ways to avoid HIV, or deal with it if they test positive.

There were 21,502 people living with HIV or AIDS in the Bronx in 2006. The disease killed 357 residents of the borough that year, about a third of all AIDS deaths in the city.