Patient Perceptions and Acceptance of Routine Emergency Department HIV Testing

Brown, Jeremy; Kuo, Irene; Bellows, Jennifer W.; Barry, Ryan; Bui, Peter; Wohlgemuth, Joshua; Wills, E.; Parikh, Nirav

doi:10.1177/00333549081230s304

Cited by 79 publications

(66 citation statements)

References 7 publications

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“…Brown et al 28 also performed an HIV screening program based on the CDC recommendations for testing in health care settings, with an acceptance rate of HIV screening of 53%, which is not appreciably higher than the average acceptance (51%) of other routine screening programs using the opt-in methodology [13][14][15][16][17][18][19] and much lower than ours. Thus, in addition to the use of the opt-out approach, there are several other features of our program that seem to contribute to the higher acceptance rates.…”

Section: Discussionmentioning

confidence: 73%

“…Nonetheless, the acceptance rate in our program is much higher than that noted in most testing programs that have offered routine HIV screening. [13][14][15][16][17][18][19]28,30 Although many of these routine HIV screening programs demonstrated that over half of the patients tested will accept testing, most used screening models that required separate consent for HIV testing or for study participation and did not use the opt-out approach currently recommended by the CDC. Our findings illustrate that streamlining the consent and counseling procedures and the opt-out approach for HIV testing in health care settings may promote high test acceptance in the ED.…”

Section: Discussionmentioning

confidence: 99%

“…35 Other studies have found that African Americans are likely to accept routine testing in ED and urgent care settings. 14,17,18,28,30,37 However, persons tested late in the course of their infection are more likely to be African American or Hispanic, 38 indicating that these populations may have more barriers to accessing or seeking HIV testing. African Americans residing in the south are disproportionately affected by HIV ⁄ AIDS.…”

Section: Discussionmentioning

confidence: 99%

“…Like our program, Brown et al 28 and many other programs have used outside staff to perform HIV screening; [13][14][15][16][17]30 however, many of our counselors had at least 5 years of experience providing HIV counseling and testing in outreach programs through the Medical College of Georgia. The inclusion of personnel with previous HIV counseling and testing experience may play an important role in the development and implementation of a program having high acceptance of testing.…”

Section: Discussionmentioning

confidence: 99%

“…27 The one published study in which opt-out screening was actually used showed a 53% acceptance rate. 28 Evaluation of how patients will accept HIV testing is critical in determining if recommendations by the CDC for routine screening in the ED are practical. In this article we report results from an ongoing rapid HIV screening program in a Southeastern ED that assesses acceptance rates by selected demographic characteristics.…”

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confidence: 99%

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Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

Freeman

Sattin

Miller

et al. 2009

Academic Emergency Medicine

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Objectives: The objective was to assess the acceptance of an emergency department (ED) human immunodeficiency virus (HIV) screening program based on the Centers for Disease Control and Prevention (CDC) recommendations for routine HIV screening in health care settings.Methods: Rapid HIV screening was offered on an opt-out basis to patients aged 13 to 64 years presenting to the ED by trained HIV counselors. Patients were excluded if they had a history of HIV, were physically or mentally incapacitated, did not understand their right to opt-out, or did not speak English or Spanish. Statistical analyses, including logistic regression, were performed to assess the associations between the demographics of patients offered testing and their test acceptance or refusal.Results: From March 2008 to January 2009, a total of 5,080 (91%) of the 5,585 patients offered the HIV test accepted, and 506 (9%) refused. White and married patients were less likely to accept testing than those who were African American and unmarried (p < 0.001). Adult patients were almost twice as likely to accept testing as pediatric patients (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.50 to 2.53). As age increased among pediatric patients, testing refusal decreased (OR = 0.71; 95% CI = 0.59 to 0.85), and as age increased among adult patients, testing refusal increased (OR = 1.17; 95% CI = 1.12 to 1.22). Two percent of persons accepting the test were considered high risk. Males were more likely to report high-risk behavior than females (OR = 1.83; 95% CI = 1.23 to 2.72).

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

Freeman

Sattin

Miller

et al. 2009

Academic Emergency Medicine

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Changes in Human Immunodeficiency Virus Testing Rates Among Urban Adolescents After Introduction of Routine and Rapid Testing

Mullins

Kollar²,

Lehmann³

et al. 2010

Arch Pediatr Adolesc Med

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To examine human immunodeficiency virus (HIV) testing rates among adolescents during a 3-year period to determine (1) if the rate of testing increased after publication of national recommendations for routine HIV testing in 2006, and again after the introduction of rapid testing in the clinic in 2007, and (2) factors associated with HIV testing. Design: Retrospective medical record review. Setting: Urban hospital-based adolescent primary care clinic. Participants: Thirteen-to 22-year-old sexually experienced patients who had computerized billing data reflecting testing for sexually transmitted infections, including HIV. Outcome Measures: Rates of HIV testing for each of 3 one-year phases-phase 1 (pre-routine testing recommendations), phase 2 (post-routine testing recommendations but pre-rapid testing), and phase 3 (post-rapid testing)-and factors associated with HIV testing. Results: In total, 9491 patients were included. The rate of HIV testing in phase 2 was significantly higher than the rate of testing in phase 1 (27.7% vs 12.6%, PϽ.001). The rate of testing in phase 3 was significantly higher than the rate of testing in phase 2 (44.6% vs 27.7%, PϽ.001) and phase 1 (P Ͻ .001). Factors independently associated with HIV testing included phase, older age, male sex, race, public insurance status, and having a genitourinaryrelated diagnosis during the same phase. Conclusions: The HIV testing rates increased significantly following publication of recommendations for routine testing and further increased following introduction of rapid testing. Combining routine and rapid testing strategies may increase uptake of HIV testing among adolescents in primary care settings.

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Testing for HIV infection in the emergency departments of 2 hospitals in the Southeastern United States

et al. 2020

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Background In 2006, the Centers for Disease Control and Prevention (CDC) recommended non‐targeted, opt‐out HIV screening in all healthcare settings, including emergency departments (EDs). Multiple HIV testing programs have been implemented in EDs across the United States with varying designs and testing platforms. We report findings from a free, non‐targeted, rapid HIV testing program in 2 EDs in the Southeastern United States. Methods From 2008 to 2012, adults ≥18 years of age were offered free rapid HIV testing using an oral swab test (OraQuick ADVANCE Rapid HIV‐1/2 antibody test) in the EDs of a large academic medical center and an affiliated community hospital in Durham, North Carolina. Results In total, 5443 ED patients were offered HIV testing. The overall acceptance rate was 66.9% (3639/5443). Younger persons were significantly more likely to accept testing (78.2% for 18–29 years old vs 67.1% for ≥30 years old; P < 0.001) as were Black participants (72.6% Black vs 66.5% White; P < 0.001). Acceptance rates improved significantly after opt‐out oral consent replaced written consent (71.3% vs 63.1%; P < 0.001). Seven new HIV diagnoses were confirmed during the testing program, resulting in a seropositivity rate of 0.19% (7/3639). There were 8 false–positive rapid oral HIV tests (positive predictive value = 46.7%). Conclusions Although the number of new HIV diagnoses was low, implementation of this rapid, non‐targeted ED screening program was feasible with high acceptance rates, particularly after introducing the opt‐out oral consent approach.

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Patient Perceptions and Acceptance of Routine Emergency Department HIV Testing

Abstract: The Centers for Disease Control and Prevention's 2006 recommendations on HIV screening are well accepted by the target populations. Further work at explaining the risk of HIV infection to ED patients should be undertaken and may boost the acceptance rate of ED HIV screening.

Cited by 79 publications

References 7 publications

Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

Changes in Human Immunodeficiency Virus Testing Rates Among Urban Adolescents After Introduction of Routine and Rapid Testing

Testing for HIV infection in the emergency departments of 2 hospitals in the Southeastern United States

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