Scope of Rapid HIV Testing in Urban U.S. Hospitals

Abstract

SYNOPSISObjective. The present study examined the scope of rapid human immunodeficiency virus (HIV) testing in urban U.S. hospitals.Methods. In a multistage national probability sample, 12 primary metropolitan statistical areas (three per region) were sampled randomly, with weights proportionate to acquired immunodeficiency syndrome (AIDS) populations. All 671 eligible hospitals within areas were selected. Laboratory staff from 584 hospitals (87%) were interviewed by telephone in 2005.Results. About 52% reported rapid HIV test availability (50% in occupational health, 29% in labor and delivery, and 13% in emergency department/urgent care), and 86% of hospitals offering rapid tests processed them in the laboratory. In multivariate models, rapid test availability was more likely in hospitals serving more patients, and located in high-poverty, high-AIDS prevalence areas, and in the South or Midwest vs. West. It was less likely in hospitals serving areas with large percentages of people who were black/African American or Hispanic/Latino (p,0.05).Conclusions. Rapid HIV testing is increasing across urban U.S. hospitals, primarily for occupational exposure and in hospitals with greater resources and need. To achieve routine HIV screening, policies should encourage greater breadth of diffusion of rapid testing at the point of care, especially in smaller facilities, the West, and communities with racial/ethnic diversity.

A Qualitative Assessment of Emergency Department Patients' Knowledge, Beliefs, Attitudes, and Acceptance Toward Revised HIV Testing Strategies

“…Despite recent moves to increase implementation of these guidelines by individual states, and an increase in ED‐based HIV testing programs, there are few empirical data on ED patients' knowledge, beliefs, attitudes, and acceptance toward these revised HIV testing strategies . Studies that have examined patients' acceptance of revised HIV testing strategies tend to focus on the number of patients who accept or refuse an offer of HIV testing, but do not always delve deeply into the reasons behind these decisions .…”

Nonoccupational Postexposure HIV Prophylaxis in Sexual Assault Programs: A Survey of SANE and FNE Program Coordinators

“…The cost of an oral or serum rapid HIV test is relatively inexpensive ranging from approximately $8 to $25, not including the cost of the control packs (CDC, 2008). While use of rapid HIV testing is increasing (Thornton, Delpech, Kall, & Nardone, 2012), limited availability of rapid HIV testing for sexual assault survivors continues in the United States (Bogart et al, 2008) and for any population in Canada (Lee, Plitt, Fenton, Preiksaitis, & Singh, 2011; Thornton et al, 2012). …”

Point-of-Care Testing in the Time of P5 Medicine: A Preface

“…(8) HIV testing, the foremost imperative for preventing further transmission and to caring for those infected, is traditionally performed outside of the clinical encounter in centralized laboratories. (9) Tested individuals are asked to return several weeks post-test to learn the results, and for treatment and prevention counseling, to reduce risky behaviors among those found to be infected. However, more than one third of those tested do not return for results, representing a missed prevention opportunity.…”

“…POC testing for screening, diagnosis, treatment initiation, and the monitoring of HIVtreatment efficacy helps resolve these deficiencies by allowing infected individuals to learn their serostatus quickly and by connecting them to medical care. (9) Low cost, user-friendly, and accurate HIV diagnostic tests, patterned after home pregnancy tests, are particularly enabling for those individuals who may not otherwise test. Direct ways of measuring the amount of the HIV virus present (viral load) allows monitoring of how advanced the infection is and how well treatment is working.…”