The Use of a Computer Reminder System in an Emergency Department Universal HIV Screening Program

2011 ◽  
Vol 58 (1) ◽  
pp. S71-S73.e1 ◽  
Author(s):  
Lee Wilbur ◽  
Gretchen Huffman ◽  
Stephanie Lofton ◽  
John T. Finnell
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Hiv Screening ◽  
Reminder System ◽  
Computer Reminder

scholarly journals 845. Impact of the COVID-19 Pandemic on Routine HIV Screening in an Emergency Department

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S513-S513
Author(s):  
Elizabeth A Aguilera ◽  
Gilhen Rodriguez ◽  
Gabriela P Del Bianco ◽  
Gloria Heresi ◽  
James Murphy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Medical Center ◽  
Hiv Infections ◽  
Hiv Screening ◽  
Opt Out ◽  
Number Of Patients ◽  
Confirmatory Tests ◽  
Routine Hiv Screening ◽  
The Impact

Abstract Background The Emergency Department (ED) at Memorial Hermann Hospital (MHH) - Texas Medical Center (TMC), Houston, Texas has a long established screening program targeted at detection of HIV infections. The impact of the COVID-19 pandemic on this screening program is unknown. Methods The Routine HIV screening program includes opt-out testing of all adults 18 years and older with Glasgow score > 9. HIV 4th generation Ag/Ab screening, with reflex to Gennius confirmatory tests are used. Pre-pandemic (March 2019 to February 2020) to Pandemic period (March 2020 to February 2021) intervals were compared. Results 72,929 patients visited MHH_ED during the pre-pandemic period and 57,128 in the pandemic period, a 22% decline. The number of patients tested for HIV pre-pandemic was 9433 and 6718 pandemic, a 29% decline. When the pandemic year was parsed into first and last 6 months interval and compared to similar intervals in the year pre pandemic, 39% followed by 16% declines in HIV testing were found. In total, 354 patients were HIV positives, 209, (59%) in the pre-pandemic and 145 (41%) in the pandemic period.The reduction in new HIV infections found was directly proportional to the decline in patients visiting the MHH-ED where the percent of patients HIV positive was constant across intervals (2.21% vs 2.26%). Demographic and outcome characteristics were constant across the compared intervals. Conclusion The COVID -19 pandemic reduced detection of new HIV infections by screening in direct proportion to the reduction in MHH-ED patient visits. The impact of COVID-19 pandemic decreased with duration of the pandemic. Disclosures All Authors: No reported disclosures

Evaluation of a rapid point-of-care HIV screening program in an emergency department setting in Detroit, Michigan

2018 ◽  
Vol 106 ◽  
pp. 11-12 ◽  
Author(s):  
Weiming Zhu ◽  
Kimberly Mumby ◽  
Doreen Dankerlui ◽  
Jake Manteuffel ◽  
Cal Ham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Point Of Care ◽  
Hiv Screening ◽  
Emergency Department Setting

Missed Opportunities for Earlier HIV Diagnosis in an Emergency Department Despite an HIV Screening Program

2009 ◽  
Vol 23 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Douglas A.E. White ◽  
Otis U. Warren ◽  
Alicia N. Scribner ◽  
Bradley W. Frazee
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Hiv Screening ◽  
Hiv Diagnosis ◽  
Missed Opportunities

scholarly journals Factors associated with patients who prefer HIV self-testing over health professional testing in an emergency department-based rapid HIV screening program

2017 ◽  
Vol 28 (11) ◽  
pp. 1124-1129 ◽  
Author(s):  
Yu-Hsiang Hsieh ◽  
Kaylin J Beck ◽  
Richard E Rothman ◽  
Megan Gauvey-Kern ◽  
Alonzo Woodfield ◽  
...  
Keyword(s):  
Emergency Department ◽  
Screening Program ◽  
Standard Of Care ◽  
Hiv Screening ◽  
Factors Associated ◽  
Self Testing ◽  
Chi Squared ◽  
Conventional Modality ◽  
Stage System ◽  
English Speaking

Kiosk-facilitated HIV self-testing has been shown to be accurate and well accepted by emergency department (ED) patients. We investigated factors associated with patients who preferred self-testing over testing performed by health professionals in an ED-based HIV screening program. This opt-in program evaluation studied 332 patients in an inner-city academic ED from February 2012 to April 2012, when a kiosk-based HIV self-testing program was standard of care. The first kiosk in the 2-stage system registered patients and assessed their interest in screening, while the second kiosk gathered demographic and risk factor information and also provided self-testing instructions. Patients who declined to self-test were offered testing by staff. Broad eligibility included patients aged 18–64 years who were not critically ill, English-speaking, able to provide informed consent, and registered during HIV program operational hours. Data were analyzed using descriptive statistical analysis and Chi squared tests; 160 (48.2%) of 332 patients consenting to testing chose to use a kiosk to guide them performing self-testing. Patients aged 25–29 years and those whose primary ED diagnosis was not infectious disease-related were more likely to prefer HIV self-testing (OR = 2.19, 95% CI: 1.17–4.10; OR = 1.79, 95% CI: 1.03–3.12). HIV self-testing in the ED could serve as a complementary testing approach to the conventional modality.

scholarly journals 1299. Cluster of False-Positive “Fifth-Generation” HIV Test Results During Implementation of a Routine HIV Screening Program in an Emergency Department

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S468-S468
Author(s):  
Andrew B Trotter ◽  
Anjana Maheswaran ◽  
Mary Kate Mannion ◽  
Sara Baghikar ◽  
Janet Lin
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
False Positive ◽  
Screening Program ◽  
False Positives ◽  
Hiv Screening ◽  
Fifth Generation ◽  
Hiv Test ◽  
Hiv Antigen ◽  
Hiv 1

Abstract Background In November 2014, the University of Illinois Hospital (UI Health) introduced an electronic medical record (EMR)-driven HIV screening program in the emergency department (ED). In October 2016, our hospital laboratory introduced “Fifth-generation” HIV testing using the Bio-Rad BioPlex 2200 HIV Antigen/Antibody diagnostic assay. Fifth-generation HIV testing has the advantage of separately detecting and reporting HIV antibody and HIV-1 p24 antigen. Although the literature and manufacturer report high sensitivity and specificity of this test, we encountered higher than expected rates of false-positive tests during the introduction of this test. Methods We retrospectively reviewed the results of our ED HIV screening program from October 2016 to March 2019 to describe the outcomes of HIV testing, determine the rates of false-positive HIV tests and determine if false-positive rates were temporally clustered. We also investigated various potential causes of higher than expected false positives including pre-analytical and analytical error. We defined a false-positive test as a repeatedly reactive initial HIV antigen and/or HIV-1 antibody result with a subsequent negative or indeterminate HIV-1/2 antibody differentiation immunoassay and negative HIV-1 nucleic amplification test. Results During the review period, out of a total of 17,385 HIV tests which were performed, 85 tests were confirmed positive and 27 were false positives. This represents an HIV prevalence of 0.5%. Eighteen of the 27 false positives occurred during an 8 month period between October 2016 and April 2017 (see Figure 1). During our investigation of potential causes of the false-positive tests, we discovered that a reagent lot for the test was changed in June 2017 which resulted in a significant decrease in the false-positive rate (0.33% to 0.07%). Conclusion We provide data which suggests that a reagent lot may have been the cause of higher than expected false-positive tests for HIV testing. Monitoring of testing outcomes during implementation of a routine HIV testing program can help identify potential root causes of false-positive tests. Disclosures All authors: No reported disclosures.

scholarly journals Design and Implementation of an Emergency Department (ED) Based Rapid HIV Screening Program

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Fredric Hustey ◽  
Michael Phelan ◽  
Sharon O’Keefe ◽  
Tracy Barbour
Keyword(s):  
Emergency Department ◽  
Cohort Study ◽  
Outpatient Care ◽  
Screening Program ◽  
Hiv Positive ◽  
Hiv Screening ◽  
Design And Implementation ◽  
Risk Patients ◽  
Positive Results

This was a prospective cohort study involving an ED rapid HIV screening program targeting high risk patients. 1090 patients underwent ED HIV testing over a 33 month period. 43% (467/1090) were male and 74%(804/1090) were African American. Mean age was 27 years. 32/1090 tested positive of which 31 were confirmed on follow up testing (3%; 95%CI, 2-4%). 27/31 patients were previously undiagnosed (87%; 95%CI, 71-95%), while 4 patients had reported prior positive results.100% of HIV positive patients were linked to outpatient care. ED testing, including linkage to outpatient care is feasible, and yielded higher rates of HIV than previously reported.

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