scholarly journals The Prevalence of Undiagnosed HIV Infection in Those Who Decline HIV Screening in an Urban Emergency Department

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
M. Czarnogorski ◽  
J. Brown ◽  
V. Lee ◽  
J. Oben ◽  
I. Kuo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Hiv Screening ◽  
Opt Out ◽  
Undiagnosed Hiv ◽  
Routine Hiv Screening ◽  
The Difference ◽  
Routine Hiv Testing ◽  
Urban Emergency Department

Objective. To determine the prevalence of occult HIV infection in patients who decline routine HIV testing in an urban emergency department.Design, Setting, and Patients. Discarded blood samples were obtained from patients who had declined routine ED HIV testing. After insuring that the samples came from patients not known to be HIV positive, they were deidentified, and rapid HIV testing was preformed using 5 μL of whole blood.Main Outcome Measures. The prevalence of occult HIV infection in those who declined testing compared with prevalence in those who accepted testing.Results. 600 consecutive samples of patients who declined routine HIV screening were screened for HIV. Twelve (2%) were reactive. Over the same period of time, 4845 patients accepted routine HIV testing. Of these, 35 (0.7%) were reactive. The difference in the prevalence of HIV infection between those who declined and those who accepted testing was significant (). The relative risk of undetected HIV infection in the group that declined testing was 2.74 times higher (95% CI 1.44–5.18) compared with those accepted testing.Conclusion. The rate of occult HIV infection is nearly three-times higher in those who decline routine ED HIV testing compared with those who accept such testing. Interventions are urgently needed to decrease the opt-out rate in routine ED HIV testing settings.

Routine HIV Screening in Cancer Patients in the Emergency Department

2018 ◽  
Vol 17 (2) ◽  
pp. 91-95
Author(s):  
Terry W Rice ◽  
◽  
Patricia A. Brock ◽  
Carmen Gonzalez ◽  
Kelly W Merriman ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hiv Testing ◽  
Cancer Patients ◽  
Linkage To Care ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Hiv Screening ◽  
Immunodeficiency Virus ◽  
Routine Hiv Screening ◽  
Incident Cases

Treatment of human immunodeficiency virus(HIV) in cancer patients improves outcomes and reduces transmission of this oncogenic virus. HIV testing rates of cancer patients are similar to the general population (15-40%), despite the association with cancer. Our aim was to increase HIV screening in the Emergency Department(ED) of a comprehensive cancer center through a quality initiative. Testing increased significantly during the intervention (p<0.001; 0.15/day to 2.69/day). Seropositive HIV rate was 1.4% (12/852), with incidence of 0.3%. All patients were linked to care. Incident cases were between 36 and 55 years of age. Barriers encountered included confusion regarding the need for written consent for HIV testing, failure to consider ordering the test, and concerns regarding linkage to care.

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 &gt; 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

scholarly journals HIV Testing: Support for Routine Screening

1970 ◽  
Vol 10 (1) ◽  
Author(s):  
Brett Edwards, BSc. Pharm ◽  
Stephen Vaughan MD DTMH
Keyword(s):  
Hiv Testing ◽  
Task Force ◽  
Preventive Services ◽  
The United States ◽  
Routine Screening ◽  
Hiv Screening ◽  
Screening Cost ◽  
National Body ◽  
Routine Hiv Screening ◽  
Routine Hiv Testing

This article discusses the recent evolution of human immunodeficiency virus (HIV) screening recommendations with significantly expanded role for routine HIV testing. After the Centre for Disease Control (CDC) released recommendations for routine screening in 2006, it was anticipated that the United States Preventive Services Task Force (USPSTF), a national body charged with providing evidence-based recommendations for preventive services, would follow shortly. However, they refrained, citing a lack of evidence at the time to make such a recommendation, and maintained a recommendation for risk-based screening. Following an analysis of recent literature, in 2013 the USPSTF finally made a recommendation for routine HIV screening on the grounds of new evidence. The recommendations are based on the clinical benefit, the failures of risk-based screening, cost-effectiveness data with reduction in HIV related morbidity/mortality, and lower rates of transmission. This article highlights some of the literature that accounted for the change in recommendations and provides a basic review of HIV testing techniques available to the internists and the recommendations for routine screening of patients.

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