HIV and HCV screening among trauma patients

2019 ◽  
Vol 30 (7) ◽  
pp. 663-670
Author(s):  
Gina M Simoncini ◽  
Josue Oyola-Jimenez ◽  
Davone Singleton ◽  
Jill Volgraf ◽  
Frederick V Ramsey ◽  
...  
Keyword(s):  
Screening Program ◽  
Trauma Surgery ◽  
Linkage To Care ◽  
Care Program ◽  
Hiv Infections ◽  
Trauma Patients ◽  
Hiv Screening ◽  
Care Services ◽  
Trauma Service ◽  
Hcv Antibody

The purpose of this study was to develop a hepatitis C virus (HCV) and HIV screening program for patients evaluated by the trauma service and link to care. Patients were offered screening for HCV antibody and HIV. Demographics were collected on gender, race, age, and history of intravenous drug use. A navigator connected patients to treatment. In total, 1160 trauma patients were screened for HCV and/or HIV. There were 162 (14%) patients with HCV antibodies. Patients who inject drugs comprised 39.5% (64) of the HCV antibody positive group. Forty-six (68.7%) patients received linkage to care services and 55 (34%) patients were actively engaged in treatment. There were 155 (10.5%) of all eligible patients screened for HIV. Twenty-one (13.5%) patients were living with HIV (PLWH) and there were two (1.3%) new HIV infections. All new PLWH were linked to care and a total of 14 (73.7%) PLWH were on antiretroviral therapy. This is the first HCV and HIV screening and linkage to care program of trauma surgery patients. In this interim program evaluation, we found high prevalence of HCV antibody and HIV prevalence and high linkage to care rates. Trauma service HCV and HIV screening is an opportunity to diagnose, link, and re-engage a vulnerable population.

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

scholarly journals Development and pilot testing of HIV screening program integration within public/primary health centers providing antenatal care services in Maharashtra, India

2014 ◽  
Vol 7 (1) ◽  
Author(s):  
Suchitra V Bindoria ◽  
Ramesh Devkar ◽  
Indrani Gupta ◽  
Virupax Ranebennur ◽  
Niranjan Saggurti ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Screening Program ◽  
Health Centers ◽  
Hiv Screening ◽  
Pilot Testing ◽  
Care Services ◽  
Primary Health ◽  
Program Integration

scholarly journals Implementation of a Large System-Wide Hepatitis C Virus Screening and Linkage to Care Program for Baby Boomers

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Mariana Castrejón ◽  
Kara W. Chew ◽  
Marjan Javanbakht ◽  
Romney Humphries ◽  
Sammy Saab ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Baby Boomers ◽  
Linkage To Care ◽  
Care Program ◽  
Hcv Rna ◽  
Care Coordinator ◽  
Hcv Antibody ◽  
Hcv Screening

Abstract Background We implemented and evaluated a large health system-wide hepatitis C virus (HCV) screening and linkage to care program for persons born between 1945 and 1965 (“baby boomers”). Methods An electronic health record (EHR) clinical decision support (CDS) tool for HCV screening for baby boomers was introduced in August 2015 for patients seen in the outpatient University of California, Los Angeles healthcare system setting. An HCV care coordinator was introduced in January 2016 to facilitate linkage to HCV care. We compared HCV testing in the year prior (August 2014–July 2015) to the year after (August 2015–July 2016) implementation of the CDS tool. Among patients with reactive HCV antibody testing, we compared outcomes related to the care cascade including HCV ribonucleic acid (RNA) testing, HCV RNA positivity, and linkage to HCV specialty care. Results During the study period, 19606 participants were screened for HCV antibody. Hepatitis C virus antibody screening increased 145% (from 5676 patients tested to 13930 tested) after introduction of the CDS intervention. Screening increased across all demographic groups including age, sex, and race/ethnicity, with the greatest increases among those in the older age groups. The addition of an HCV care coordinator increased follow-up HCV RNA testing for HCV antibody positive patients from 83% to 95%. Ninety-four percent of HCV RNA positive patients were linked to care postimplementation. Conclusions Introduction of an EHR CDS tool and care coordination markedly increased the number of baby boomers screened for HCV, rates of follow-up HCV RNA testing, and linkage to specialty HCV care for patients with chronic HCV infection.

scholarly journals HIV detection by an emergency department HIV screening program during a regional outbreak among people who inject drugs

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251756
Author(s):  
Kiran A. Faryar ◽  
Rachel M. Ancona ◽  
Zachary Reau ◽  
Sheryl B. Lyss ◽  
Robert S. Braun ◽  
...  
Keyword(s):  
Screening Program ◽  
Hiv Infections ◽  
Safety Net ◽  
Annual Number ◽  
Hiv Screening ◽  
Persons Who Inject Drugs ◽  
Hiv Surveillance ◽  
Screening Programs ◽  
Undiagnosed Hiv ◽  
Clinical Records

Objective Multiple HIV outbreaks among persons who inject drugs (PWID) have occurred in the US since 2015. Emergency departments (EDs), recognized as essential venues for HIV screening, may play a unique role in identifying undiagnosed HIV among PWID, who frequently present for complications of injection drug use (IDU). Our objective was to describe changes in HIV diagnoses among PWID detected by an ED HIV screening program and estimate the program’s contribution to HIV diagnoses among PWID county-wide during the emergence of a regional HIV outbreak. Methods This was a retrospective study of electronically queried clinical records from an urban, safety-net ED’s HIV screening program and publicly available HIV surveillance data for its surrounding county, Hamilton County, Ohio. Outcomes included the change in number of HIV diagnoses and the ED’s contribution to case identification county-wide, overall and for PWID during 2014–2018. Results During 2014–2018, the annual number of HIV diagnoses made by the ED program increased from 20 to 42 overall, and from 1 to 18 for PWID. We estimated that the ED contributed 18% of HIV diagnoses in the county and 22% of diagnoses among PWID. Conclusions The ED program contributed 1 in 5 new HIV diagnoses among PWID county-wide, further illustrating the importance of ED HIV screening programs in identifying undiagnosed HIV infections. In areas experiencing increasing IDU, HIV screening in EDs can provide an early indication of increasing HIV diagnoses among PWID and can substantially contribute to case-finding during an HIV outbreak.

scholarly journals Trauma surgery at a designated COVID-19-free site during the pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 302-308
Author(s):  
Gianluca Gonzi ◽  
Kathryn Rooney ◽  
Rhodri Gwyn ◽  
Kunal Roy ◽  
Matthew Horner ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Electronic Record ◽  
Health Board ◽  
Trauma Patients ◽  
Staff Members ◽  
Patient Demographics ◽  
Orthopaedic Patients ◽  
Trauma Service ◽  
Surgical Unit

Aims Elective operating was halted during the COVID-19 pandemic to increase the capacity to provide care to an unprecedented volume of critically unwell patients. During the pandemic, the orthopaedic department at the Aneurin Bevan University Health Board restructured the trauma service, relocating semi-urgent ambulatory trauma operating to the isolated clean elective centre (St. Woolos’ Hospital) from the main hospital receiving COVID-19 patients (Royal Gwent Hospital). This study presents our experience of providing semi-urgent trauma care in a COVID-19-free surgical unit as a safe way to treat trauma patients during the pandemic and a potential model for restarting an elective orthopaedic service. Methods All patients undergoing surgery during the COVID-19 pandemic at the orthopaedic surgical unit (OSU) in St. Woolos’ Hospital from 23 March 2020 to 24 April 2020 were included. All patients that were operated on had a telephone follow-up two weeks after surgery to assess if they had experienced COVID-19 symptoms or had been tested for COVID-19. The nature of admission, operative details, and patient demographics were obtained from the health board’s electronic record. Staff were assessed for sickness, self-isolation, and COVID-19 status. Results A total of 58 surgical procedures were undertaken at the OSU during the study period; 93% (n = 54) of patients completed the telephone follow-up. Open reduction and internal fixation of ankle and wrist fractures were the most common procedures. None of the patients nor members of their households had developed symptoms suggestive of COVID-19 or required testing. No staff members reported sick days or were advised by occupational health to undergo viral testing. Conclusion This study provides optimism that orthopaedic patients planned for surgery can be protected from COVID-19 nosocomial transmission at separate COVID-19-free sites. Cite this article: Bone Joint Open 2020;1-6:302–308.

scholarly journals Evaluation of hidden HIV infections in an urban ED with a rapid HIV screening program

2016 ◽  
Vol 34 (2) ◽  
pp. 180-184 ◽  
Author(s):  
Yu-Hsiang Hsieh ◽  
Gabor D. Kelen ◽  
Kaylin J. Beck ◽  
Chadd K. Kraus ◽  
Judy B. Shahan ◽  
...  
Keyword(s):  
Screening Program ◽  
Hiv Infections ◽  
Hiv Screening

scholarly journals Trauma surgery at a designated COVID-19-free site during the pandemic

2020 ◽  
Vol 1 (6) ◽  
pp. 302-308 ◽  
Author(s):  
Gianluca Gonzi ◽  
Kathryn Rooney ◽  
Rhodri Gwyn ◽  
Kunal Roy ◽  
Matthew Horner ◽  
...  
Keyword(s):  
Trauma Surgery ◽  
Electronic Record ◽  
Health Board ◽  
Trauma Patients ◽  
Staff Members ◽  
Patient Demographics ◽  
Orthopaedic Patients ◽  
Trauma Service ◽  
Surgical Unit

Aims Elective operating was halted during the COVID-19 pandemic to increase the capacity to provide care to an unprecedented volume of critically unwell patients. During the pandemic, the orthopaedic department at the Aneurin Bevan University Health Board restructured the trauma service, relocating semi-urgent ambulatory trauma operating to the isolated clean elective centre (St. Woolos’ Hospital) from the main hospital receiving COVID-19 patients (Royal Gwent Hospital). This study presents our experience of providing semi-urgent trauma care in a COVID-19-free surgical unit as a safe way to treat trauma patients during the pandemic and a potential model for restarting an elective orthopaedic service. Methods All patients undergoing surgery during the COVID-19 pandemic at the orthopaedic surgical unit (OSU) in St. Woolos’ Hospital from 23 March 2020 to 24 April 2020 were included. All patients that were operated on had a telephone follow-up two weeks after surgery to assess if they had experienced COVID-19 symptoms or had been tested for COVID-19. The nature of admission, operative details, and patient demographics were obtained from the health board’s electronic record. Staff were assessed for sickness, self-isolation, and COVID-19 status. Results A total of 58 surgical procedures were undertaken at the OSU during the study period; 93% (n = 54) of patients completed the telephone follow-up. Open reduction and internal fixation of ankle and wrist fractures were the most common procedures. None of the patients nor members of their households had developed symptoms suggestive of COVID-19 or required testing. No staff members reported sick days or were advised by occupational health to undergo viral testing. Conclusion This study provides optimism that orthopaedic patients planned for surgery can be protected from COVID-19 nosocomial transmission at separate COVID-19-free sites. Cite this article: Bone Joint Open 2020;1-6:302–308.

scholarly journals Linkage to Care, Antiretroviral Treatment Initiation, and Viral Suppression of Acute HIV-Infected Individuals Identified From an Emergency Department–Based HIV Screening and Linkage-to-Care Program

2018 ◽  
Vol 72 (5) ◽  
pp. 621-623 ◽  
Author(s):  
Serban Negoita ◽  
Richard E. Rothman ◽  
Danielle Signer ◽  
Madeleine Whalen ◽  
Erin Ricketts ◽  
...  
Keyword(s):  
Emergency Department ◽  
Antiretroviral Treatment ◽  
Viral Suppression ◽  
Treatment Initiation ◽  
Linkage To Care ◽  
Care Program ◽  
Hiv Screening ◽  
Acute Hiv

scholarly journals Evolution and Escalation of an Emergency Department Routine, Opt-out HIV Screening and Linkage-to-Care Program

2016 ◽  
Vol 131 (1_suppl) ◽  
pp. 96-106 ◽  
Author(s):  
James W. Galbraith ◽  
James H. Willig ◽  
Joel B. Rodgers ◽  
John P. Donnelly ◽  
Andrew O. Westfall ◽  
...  
Keyword(s):  
Emergency Department ◽  
Linkage To Care ◽  
Care Program ◽  
Hiv Screening ◽  
Opt Out

Factors Associated with Non-acceptance of HIV Testing in Alberta's Opt-Out Prenatal HIV Screening Program

2004 ◽  
Author(s):  
Fun-Lin Wang ◽  
A. Singh ◽  
D. Schopflocher ◽  
S. Gabos
Keyword(s):  
Hiv Testing ◽  
Screening Program ◽  
Hiv Screening ◽  
Factors Associated ◽  
Opt Out
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