HIV Testing and Referral to Care in U.S. Hospitals Prior to 2006: Results from a National Survey

Torres, Gretchen Williams; Yonek, Juliet; Pickreign, Jeremy; Whitmore, Heidi; Hasnain‐Wynia, Romana

doi:10.1177/003335490912400309

Cited by 10 publications

(3 citation statements)

References 18 publications

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“…As a result, HIV screening activity in EDs across the US increased. In 2004, less than 2% of EDs offered HIV screening (32), but by 2009, a quarter of EDs offered some type of organized HIV screening program (33). …”

Section: Discussionmentioning

confidence: 99%

Improvements in the continuum of HIV care in an inner-city emergency department

Kelen

Hsieh²,

Rothman³

et al. 2016

Aids

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Objective The Johns Hopkins Hospital Emergency Department (JHH-ED) has served as a window on the HIV epidemic for 25 years, and as a pioneer in ED-based screening/linkage-to-care (LTC) programs. We document changes in the burden of HIV and HIV care metrics to the evolving HIV epidemic in inner-city Baltimore. Design/Methods We analyzed seven serosurveys conducted on 18,144 adult JHH-ED patients between 1987–2013 as well as our HIV screening/LTC program (2007, 2013) for trends in HIV prevalence, cross-sectional annual incidence estimates, undiagnosed HIV, LTC, antiretrovirals (ARVs) treatment, and viral suppression. Results HIV prevalence in 1987 was 5.2%, peaked at >11% from 1992–2003 and declined to 5.6% in 2013. Seroprevalence was highest for black males (initial 8.0%, peak 20.0%, last 9.9%) and lowest for white females. Among HIV+ individuals, proportion of undiagnosed infection was 77% in 1987, 28% in 1992, and 12% by 2013 (p<0.001). Cross-sectional annual HIV incidence estimates declined from 2.28% in 2001 to 0.16% in 2013. Thirty-day LTC improved from 32% (2007) to 72% (2013). In 2013, 80% of HIV+ individuals had ARVs detected in sera, markedly increased from 2007 (27%) (p<0.001). Proportion of HIV+ individuals with viral suppression (<400 copies/ml) increased from 23% (2001) to 59% (2013) (p<0.001). Conclusions ED-based HIV testing has evolved from describing the local epidemic to a strategic interventional role, serving as a model for early HIV detection and LTC. Our contribution to community-based HIV-screening and LTC program parallels declines in undiagnosed HIV infection and incidence, and increases in ARV use with associated viral suppression in the community.

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Section: Discussionmentioning

confidence: 99%

Improvements in the continuum of HIV care in an inner-city emergency department

Kelen

Hsieh²,

Rothman³

et al. 2016

Aids

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“…10 Previous research has shown that the teaching status and size of hospitals, as well as the region and type of metropolitan area in which they are located, are associated with the availability of HIV testing in hospitals. 11 However, there are few published data about hospital characteristics that are associated with the adoption of CDC's revised testing recommendations, and existing studies do not consider the impact of external factors, such as state regulations or third-party reimbursement policies, that might influence whether hospitals adopt the testing guidelines. Also unknown is how the screening practices of hospitals that serve larger proportions of low-income and minority patients compare with the practices of other hospitals.…”

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confidence: 99%

HIV Screening Practices and Hospital Characteristics in the U.S., 2009–2010

et al. 2013

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“…4 However, the extent to which HIV screening is being conducted in hospital settings nationally is unknown. Surveys conducted before the 2006 CDC recommendations showed that few hospitals screened patients for HIV outside of labor and delivery 5 and that HIV screening in EDs was uncommon, 6,7 despite evidence of missed opportunities for diagnosis of HIV in health-care settings. [8][9][10] To assess hospital adoption of CDC HIV screening recommendations, we surveyed a sample of American Hospital Association (AHA) member hospitals during 2009-2010.…”

mentioning

confidence: 99%