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Because HIV testing is not available in the places where most people in Atlanta see their doctors, by the time Atlanta residents are diagnosed with the virus, nearly 3 out of 10 already have full-blown AIDS, WABE reports.

That’s what experts found after they went digging for why Atlanta emerged fifth on a list of U.S. cities that have the highest number of new HIV diagnoses (pdf).

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Atlanta’s Grady Hospital started to run a testing program in its emergency room that offers a free HIV test to every patient who comes in, regardless of why patients are there. Since the program began in 2013, approximately two or three patients have been diagnosed with HIV every single day.

“This is something that keeps me awake at night in Atlanta," Dr. Abigail Hankin-Wei, the coordinator of Grady’s HIV-testing program, said.

“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,” Hankin-Wei continued.  

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Even though there are 50 places in Atlanta where one can get tested for HIV, many people aren’t going to those places. According to WABE, if HIV is left untreated, it takes eight to 10 years to progress to AIDS.

People aren’t getting tested because of socioeconomic factors, the fear that they’ll get a positive diagnosis and transportation barriers getting to the facilities that offer testing. As a result, the Centers for Disease Control and Prevention recommended routine HIV testing in 2006.

To date, the HIV-testing program in Grady is the only one in Atlanta that heeded that recommendation.

Read more at WABE.