Routine HIV Screening in the Emergency Department Using the New US Centers for Disease Control and Prevention Guidelines

Abstract

The implementation of the CDC recommendations establishing routine opt-out HIV screening programs in EDs is feasible. Further efforts to establish routine ED HIV testing are therefore warranted.

Acceptance of Rapid HIV Screening in a Southeastern Emergency Department

“…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.…”

“…16 Other routine testing studies that included both adult and adolescent patients found that younger age groups were more likely to agree to test, 30 while others found no difference in acceptance by age. 18 Most routine HIV testing programs did not include testing the pediatric population.…”

“…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.…”

“…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.…”

The Prevalence and Correlates of Receiving Confirmatory HIV Test Results Among Newly Diagnosed HIV-Positive Individuals at a Community-Based Testing Center

“…Prior studies have reported that between 50% and 100% of individuals who receive a reactive rapid HIV test take a confirmatory HIV test (Antonio-Gaddy et al, 2006;Begley et al, 2008;Brown et al, 2007;CDC, 2007;Guenter et al, 2008;Kelen et al, 1999) and between 49% and 100% of the individuals who receive a confirmatory HIV test return for the results (Antonio-Gaddy et al, 2006;Begley et al, 2008;Bucher et al, 2007;CDC, 2007;Delaney et al, 2011;Freeman, Sattin, Miller, Dias, & Wilde, 2009;Guenter et al, 2008, Kassler et al, 1997Spielberg et al, 2005). To date, no studies have examined the predictors of returning for confirmatory HIV test results.…”