A Targeted, Conventional Assay, Emergency Department HIV Testing Program Integrated With Existing Clinical Procedures

Schrantz, Stephen; Babcock, Christine; Theodosis, Christian; Brown, Stephen; Mercer, S. J.; Pillow, M. Tyson; Watts, Kathryn; Taylor, Michelle; Pitrak, David

doi:10.1016/j.annemergmed.2011.03.031

Cited by 19 publications

(22 citation statements)

References 21 publications

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“…However, it should be recalled that ED patients typically decline HIV testing out of a belief that they are not at risk for an infection, [53][54][55][56][57][58][59][60][61][62][63][64][65] and many patients who decline testing do have significant risk for having an undiagnosed infection. 21 When an opt-out approach without a risk assessment is used by ED clinicians, patients likely conduct their own risk assessment internally and perhaps subconsciously, and maybe inaccurately.…”

Section: Self-perceived Hiv Risk In Lower-risk Patientsmentioning

confidence: 99%

Is Self-Perceived HIV Risk Congruent with Reported HIV Risk Among Traditionally Lower HIV Risk and Prevalence Adult Emergency Department Patients? Implications for HIV Testing

Pringle

Merchant

Clark

2013

AIDS Patient Care and STDs

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Because reliance on patients' self-perceived risk for HIV might mislead emergency department (ED) clinicians on the need for HIV testing, we aimed to measure congruency between self-perceived and reported HIV risk in a traditional lower prevalence, lower-risk cohort. A random sample of 18-to 64-year-old patients at a large academic urban ED who were by self-report not men-who-have-sex-with-men (MSM) or injection-drug users (IDUs) were surveyed regarding their self-perceived and reported HIV risk. Sixty-two percent of participants were white non-Hispanic, 13.8% Black, and 21.2% Hispanic; and 66.9% previously had been tested for HIV. Linear regression models were constructed comparing self-perceived to reported HIV risk. Among the 329 female ED patients, 50.5% perceived that they were ''not at risk'' for HIV, yet only 10.9% reported no HIV risk behaviors, while among the 175 male ED patients, 50.9% perceived that they were ''not at risk'' for HIV, yet only 12.6% reported no HIV risk behaviors. Only 16.9% of women and 15.7% of men who had no self-perceived risk for HIV also reported no HIV risk behaviors. Multivariable linear regression demonstrated a weak relationship between self-perceived and reported risk. Congruency between self-perceived risk and reported HIV risk was low among these non-MSM, non-IDU ED patients.

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Section: Self-perceived Hiv Risk In Lower-risk Patientsmentioning

confidence: 99%

Is Self-Perceived HIV Risk Congruent with Reported HIV Risk Among Traditionally Lower HIV Risk and Prevalence Adult Emergency Department Patients? Implications for HIV Testing

Pringle

Merchant

Clark

2013

AIDS Patient Care and STDs

View full text Add to dashboard Cite

show abstract

“…The positive HIV test rate in urban EDs is higher than the local seroprevalence, which implies the cost effectiveness of screening in EDs (Table 3) (9,11,12,16,19,25,26,28,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Therefore, the US CDC recommends ED HIV screening and suggests that this strategy is particularly effective in health care facilities with HIV prevalence rates above 0.1z.…”

Section: Discussionmentioning

confidence: 99%

“…Other factors involved in HIV testing in the ED: A stratified analysis was performed to test the effects of previous HIV testing among patients who underwent the HIV test in the ED (Table 2) (9,11,12,16,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Of patients who underwent an HIV test at our ED, men who had sex with men (OR: 2.43, 95z CI: 1.01-5.87, P ＝ 0.0419), patients who had sex with a different gender (OR: 1.74, 95z CI: 1.34-2.25, P ＜ 0.0001), patients who had sex partners (OR: 1.77, 95z CI: 1.37-2.29, P ＜ 0.0001), and patients who had multiple sex partners (OR: 7.11, 95z CI: 2.72-18.59, P ＜ 0.0001) were associated with having previously been tested.…”

Section: Demographic Information Of Patients Visiting the Edmentioning

confidence: 99%

Rapid Human Immunodeficiency Virus Screening in an Emergency Department in a Region with Low HIV Seroprevalence

Shih

Hsu

et al. 2015

Jpn J Infect Dis

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“…At least 26% of ED patients meet NIAAA criteria for “at-risk” drinking [22], defined as heavy or problematic alcohol use that may lead to an array of negative consequences, including social, physical, psychological, legal and financial problems [23]. Selected US ED patient populations also have been shown to have a relatively high prevalence of undiagnosed HIV infection [24-30]. A few studies have found high proportions of ED patients who engage in HIV risk behaviors.…”

Section: Introductionmentioning

confidence: 99%

“…Studies have demonstrated a growing interest in conducting HIV screening in EDs, but uptake of HIV screening has varied across US EDs (13.0% to 99.8%) due to differences in populations studied, methods employed, and interventions or incentives offered [25-30,35-61]. HIV screening uptake in EDs has been associated with the perception of personal risk for acquiring HIV, as well as varying by patient demographic characteristics [43,62].…”

Section: Introductionmentioning

confidence: 99%

Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients

et al. 2013

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BackgroundEmergency department (ED) patients comprise a high-risk population for alcohol misuse and sexual risk for HIV. In order to design future interventions to increase HIV screening uptake, we examined the interrelationship among alcohol misuse, sexual risk for HIV and HIV screening uptake among these patients.MethodsA random sample of 18-64-year-old English- or Spanish-speaking patients at two EDs during July-August 2009 completed a self-administered questionnaire about their alcohol use using the Alcohol Use Questionnaire, the Alcohol Use Disorders Identification Test (AUDIT), and the HIV Sexual Risk Questionnaire. Study participants were offered a rapid HIV test after completing the questionnaires. Binging (≥ five drinks/occasion for men, ≥ four drinks for women) was assessed and sex-specific alcohol misuse severity levels (low-risk, harmful, hazardous, dependence) were calculated using AUDIT scores. Analyses were limited to participants who had sexual intercourse in the past 12 months. Multivariable logistic regression was used to assess the associations between HIV screening uptake and (1) alcohol misuse, (2) sexual risk for HIV, and (3) the intersection of HIV sexual risk and alcohol misuse. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were estimated. All models were adjusted for patient demographic characteristics and separate models for men and women were constructed.ResultsOf 524 participants (55.0% female), 58.4% identified as white, non-Hispanic, and 72% reported previous HIV testing. Approximately 75% of participants reported drinking alcohol within the past 30 days and 74.5% of men and 59.6% of women reported binge drinking. A relationship was found between reported sexual risk for HIV and alcohol use among men (AOR 3.31 [CI 1.51-7.24]) and women (AOR 2.78 [CI 1.48-5.23]). Women who reported binge drinking were more likely to have higher reported sexual risk for HIV (AOR 2.55 [CI 1.40-4.64]) compared to women who do not report binge drinking. HIV screening uptake was not higher among those with greater alcohol misuse and sexual risk among men or women.ConclusionsThe apparent disconnection between HIV screening uptake and alcohol misuse and sexual risk for HIV among ED patients in this study is concerning. Brief interventions emphasizing these associations should be evaluated to reduce alcohol misuse and sexual risk and increase the uptake of ED HIV screening.

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A Targeted, Conventional Assay, Emergency Department HIV Testing Program Integrated With Existing Clinical Procedures

Cited by 19 publications

References 21 publications

Is Self-Perceived HIV Risk Congruent with Reported HIV Risk Among Traditionally Lower HIV Risk and Prevalence Adult Emergency Department Patients? Implications for HIV Testing

Is Self-Perceived HIV Risk Congruent with Reported HIV Risk Among Traditionally Lower HIV Risk and Prevalence Adult Emergency Department Patients? Implications for HIV Testing

Rapid Human Immunodeficiency Virus Screening in an Emergency Department in a Region with Low HIV Seroprevalence

Interrelationship of alcohol misuse, HIV sexual risk and HIV screening uptake among emergency department patients

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