Effect of HIV Reporting by Name on Use of HIV Testing in Publicly Funded Counseling and Testing Programs

Objectives. Accessing at-risk and underserved populations for intervention remains a major obstacle for public health programs. Emergency departments (EDs) care for patients not otherwise interacting with the health care system, and represent a venue for such programs. A variety of perceived and actual barriers inhibit widespread implementation of ED-based public health programs. Collaboration between local health departments and EDs may overcome such barriers. The goal of this study was to assess the effectiveness of a health department-funded, ED-based public health program in comparison with other similar community-based programs through analysis of data reported by health department-funded HIV counseling and testing centers in one Ohio county. Method. Data for HIV counseling and testing at publicly funded sites in southwestern Ohio from January 1999 through December 2002 were obtained from the Ohio Department of Health. Demographic and risk-factor profiles were compared between the counseling and testing program located in the ED of a large, urban teaching hospital and the other publicly funded centers in the same county. Results. A total of 26,382 patients were counseled and tested; 5,232 were ED patients, and 21,150 were from community sites. HIV positivity was 0.86% (95% confidence interval [CI] 0.64%, 1.15%) in the ED and 0.65% (95% CI 0.55%, 0.77%) elsewhere. The ED program accounted for 19.8% of all tests and 24.7% of all positive results. The ED notified 77.3% of individuals testing positive and 84.4% of individuals testing negative. At community program centers, 88.3% of patients testing positive and 63.8% of patients testing negative were notified of results. All ED patients notified of positive status were successfully referred to infectious disease specialists. Conclusions. Public health programs can operate effectively in the ED. EDs should have a rapidly expanding role in the national public health system.

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Active Voluntary Counseling and Testing With Integrated CD4 Count Service Can Enhance Early HIV Testing and Early CD4 Count Measurement: Experiences From the Thai Red Cross Anonymous Clinic in Bangkok, Thailand

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e318207597f ◽

2011 ◽

Vol 56 (3) ◽

pp. 244-252 ◽

Cited By ~ 11

Author(s):

Nittaya Phanuphak ◽

Supanit Pattanachaiwit ◽

Tippawan Pankam ◽

Warabhorn Pima ◽

Anchalee Avihingsanon ◽

...

Keyword(s):

Hiv Testing ◽

Cd4 Count ◽

Red Cross ◽

Voluntary Counseling ◽

Voluntary Counseling And Testing ◽

Counseling And Testing

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From the Centers for Disease Control. Publicly funded HIV counseling and testing--United States, 1991

JAMA ◽

10.1001/jama.268.12.1519 ◽

1992 ◽

Vol 268 (12) ◽

pp. 1519-1520

Keyword(s):

United States ◽

Disease Control ◽

Publicly Funded ◽

Hiv Counseling And Testing ◽

Hiv Counseling ◽

Counseling And Testing ◽

Centers For Disease Control

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Trends in HIV seropositivity in publicly funded HIV counseling and testing programs

American Journal of Preventive Medicine ◽

10.1016/s0749-3797(97)00012-3 ◽

1998 ◽

Vol 14 (1) ◽

pp. 31-42 ◽

Cited By ~ 15

Author(s):

Ronald O. Valdiserri ◽

J.Todd Weber ◽

Robert Frey

Keyword(s):

Publicly Funded ◽

Hiv Seropositivity ◽

Hiv Counseling And Testing ◽

Hiv Counseling ◽

Counseling And Testing

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HIV Testing Behaviors Among Latina Women Tested for HIV in Florida, 2012

Hispanic Health Care International ◽

10.1177/1540415317696196 ◽

2017 ◽

Vol 15 (1) ◽

pp. 27-34 ◽

Cited By ~ 2

Author(s):

Janelle Taveras ◽

Mary Jo Trepka ◽

Purnima Madhivanan ◽

Erica L. Gollub ◽

Jessy Devieux ◽

...

Keyword(s):

United States ◽

Hiv Testing ◽

The United States ◽

Test Results ◽

Publicly Funded ◽

Latina Women ◽

Prevention Services ◽

Hiv Test ◽

Immunodeficiency Virus ◽

Racial Ethnic

Introduction: Latina women in the United States (US) are not only disproportionately affected by human immunodeficiency virus (HIV) infection but also underuse HIV prevention services, such as HIV testing. Method: HIV testing events were examined to describe the HIV testing behaviors and test results among Latinas tested in 2012 at publicly funded sites in Florida, United States. Multivariable logistic regression was used to assess the demographic characteristics associated with reports of previous testing and positive HIV test results. Results: Of the 184,037 testing events, 87,569 (45.6%) were among non-Hispanic Blacks (NHBs), 47,926 (26.0%) non-Hispanic Whites (NHWs), 41,117 (22.3%) Latinas, 5,672 (3.1%) those with unknown race/ethnicity, and 1,753 (1.0%) other racial/ethnic groups. Compared to NHW and NHB women, Latinas testing for HIV were older (mean age = 32.1, NHW = mean age 30.3, NHB = mean age 30.0; p < .0001). Results indicated that women who reported previous HIV testing had decreased odds of being Latina (adjusted odds ratio = 0.90; 95% confidence interval [0.87, 0.94]). Conclusion: These findings indicate that Latinas are underusing HIV testing, and efforts are needed to increase the proportion of Latinas, especially younger Latinas, tested for HIV in Florida.

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Opt-out HIV testing: An ethical analysis of women’s reproductive rights

Nursing Ethics ◽

10.1177/0969733011403555 ◽

2011 ◽

Vol 18 (5) ◽

pp. 734-742 ◽

Cited By ~ 7

Author(s):

Loren Fields ◽

Clair Kaplan

Keyword(s):

Hiv Testing ◽

Ethical Issues ◽

Reproductive Rights ◽

Standard Of Care ◽

Perinatal Transmission ◽

Ethical Analysis ◽

Voluntary Counseling And Testing ◽

Counseling And Testing ◽

Opt Out ◽

In Pregnancy

As the HIV epidemic continues to grow worldwide, women are increasingly and disproportionally affected. With the introduction of anti-retroviral medications that have been found to effectively prevent perinatal transmission of HIV, the approach to HIV testing in pregnant women has grown increasingly more controversial. In recent years, the model of voluntary counseling and testing (VCT) has come into question with opt-out testing now advocated for by the Centers for Disease Control and occurring widely in pregnancy. The benefits of opt-out testing are numerous and may justify its use in replacing the VCT that many have come to see as insufficient. An ethical analysis of opt-out testing suggests it may be at odds with true informed consent and involve a degree of coercion that would not be allowed outside the prenatal setting. If opt-out testing is going to remain the standard of care then the ethical issues it raises must be made transparent. Strategies need to be designed for ensuring that HIV counseling and testing in pregnancy is done in accordance with ethical and reproductive rights principles.

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