Greater Acceptance of Routine HIV Testing (Opt-Out) by Patients Attending an Infectious Disease Unit in Spain

2012 ◽  
Vol 11 (6) ◽  
pp. 341-344 ◽  
Author(s):  
Francisco Jover-Diaz ◽  
Jose-Maria Cuadrado ◽  
Mariano Matarranz ◽  
Elena Calabuig
Keyword(s):  
Hiv Testing ◽  
Test Performance ◽  
Linkage To Care ◽  
Great Majority ◽  
Routine Procedure ◽  
Opt Out ◽  
Routine Hiv Testing ◽  
Effectiveness Studies ◽  
Disease Unit ◽  
Serology Testing

Objective: Our objective was to determine attitudes and opinions of patients seen in our ID Unit on conducting HIV testing universally. Methods: The survey was conducted in patients between 18 and 65 years without known HIV infection. Requested information about the test was previous embodiment, reasons for rejection, opinion on the universal realization, benefits and/or drawbacks, possible test performance, and availability of results “test negative stigma.” Results: We surveyed 91 patients (54.9% males). Surprisingly, up to 18.7% of patients mistakenly believed that HIV testing is routinely performed without consent. A great majority (98.9%) felt that universal performance on the test would benefit mainly in early diagnosing and/or preventing transmission. Patients younger than 42 years were significantly more prone to doing the test as a routine procedure. Only 4 (4.4%) patients did not participate because they believed they were “not infected.” A vast majority (80.5%) of respondents would prefer to have results within the first 24 hours. In addition, 20.7% would have a problem with confidentiality if HIV serology testing was done. Conclusions: In summary, the vast majority (95.6%) of the surveyed patients had a fair opinion about universal HIV testing. Only 4 patients (4.4%) would not consent to HIV testing (because of low-risk perception). Availability of rapid HIV tests can facilitate fast result delivery, facilitating linkage to care. Considering favorable patients' opinion, recent opt-out screening recommendations, highest HIV prevalence in admitted patients, and cost-effectiveness, studies favor universal HIV testing.

Implementation of Routine HIV Testing in an Acute Care Hospital in Rhode Island: A Nurse-Initiated Opt-Out Pilot Project

2013 ◽  
Vol 24 (5) ◽  
pp. 460-468 ◽  
Author(s):  
Joanne F. Costello ◽  
Anne Sliney ◽  
Cindy MacLeod ◽  
Michelle Carpentier ◽  
Rebecca Garofalo ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Acute Care ◽  
Rhode Island ◽  
Acute Care Hospital ◽  
Pilot Project ◽  
Care Hospital ◽  
Opt Out ◽  
Routine Hiv Testing

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.

scholarly journals Implementing routine blood-borne virus testing for HCV, HBV and HIV at a London Emergency Department – uncovering the iceberg?

2018 ◽  
Vol 146 (8) ◽  
pp. 1026-1035 ◽  
Author(s):  
S. Parry ◽  
N. Bundle ◽  
S. Ullah ◽  
G. R. Foster ◽  
K. Ahmad ◽  
...  
Keyword(s):  
Advanced Disease ◽  
Linkage To Care ◽  
Clinic Visit ◽  
Engagement In Care ◽  
Hepatocellular Carcinomas ◽  
Opt Out ◽  
High Prevalence ◽  
Unknown Status ◽  
Routine Hiv Testing ◽  
Virus Testing

AbstractUK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 <350, APRI (AST-to-Platelet Ratio Index) >1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. ED testing was valuable as one-third of those requiring LTC (new, disengaged or unknown status patients) had advanced disease.

scholarly journals Impact of Patient Navigators in Linkage to Care for HIV-Positive Patients in an Urban Emergency Department in Newark, NJ

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S420-S420
Author(s):  
Samuel Maldonado ◽  
Gregory Sugalski ◽  
Garry Closeil ◽  
Shobha Swaminathan
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hiv Testing ◽  
Hiv Risk ◽  
Linkage To Care ◽  
Patient Navigators ◽  
Hiv Test ◽  
Routine Hiv Testing ◽  
The Impact ◽  
White Patients

Abstract Background Despite CDC recommendations, areas with high HIV prevalence have not implemented routine HIV testing, stating among other concerns, inability to effectively link them to care. We implemented a routine HIV testing program in the Emergency Department (ED) at University Hospital in Newark, NJ that had 46,164 visits from July 2015 to November 2016 and looked at the impact of patient navigators (PN) on linkage to care (LTC) rates. Methods This was a retrospective study of all patients newly diagnosed (ND) with HIV or previously positive (PP) but lost to follow-up (LTFU) in select areas of the ED from July 2015 to November 2016. We collected information on demographics, HIV risk factor, and looked at the impact of PN on LTC by comparing months the PN was able to make personal contact compared with months when the PN was unavailable for substantial periods of time. Results A total of 9,511 individuals were screened, and 151 (1.6%) had a positive HIV test; 8 died and 2 were incarcerated. Of the remaining 141, 102 (72%) were LTC. The mean age was 49, 57% Male, 77% Black, 14% Hispanic, and 6% White. The reported HIV risk factors were 67% Heterosexual, 9% MSM, 6% IV drug use (IDU) and 18% Other. Of the patients with a positive HIV test, 60 (43%) were ND and 81 (57%) were PP. Only 52% ND patients were LTC, while 88% PP patients were LTC. Black and Hispanic patients tended to be PP (60% of both groups), while White patients tended to be ND (75% of white patients were ND). The risk factors for ND were 44% Heterosexual, 39% MSM, and 25% IDU. Average LTC while the PN was unavailable decreased from 78% to 56%. There were no demographic differences in the LTC group compared with the LTFU group. IDU had the highest rate of being LTFU at 37% followed by MSM and Heterosexual at approximately 23% each. The primary reason for LTFU was incorrect contact information in the medical record such as wrong address or phone number. PN would make 3 phone calls, send 2 letters and 1 outreach attempt. If all of those failed, the PN notified the state health department. Conclusion PN have a positive impact on LTC even in busy ED settings. Given limitations of staffing a busy ED 24/7, we need to develop strategies to link patients even if the PN is not present. To address this limitation, we plan on looking at the impact of involving medical residents to help with linkage to care after business hours. Disclosures S. Swaminathan, Gilead Sciences: Grant Investigator and Scientific Advisor, Consulting fee and Research grant

Women's Opinions about Routine HIV Testing During Pregnancy: Implications for the Opt-Out Approach

2009 ◽  
Vol 23 (5) ◽  
pp. 331-337 ◽  
Author(s):  
Linda S. Podhurst ◽  
Deborah S. Storm ◽  
Sarah Dolgonos
Keyword(s):  
Hiv Testing ◽  
Opt Out ◽  
Routine Hiv Testing

scholarly journals Healthcare Provider Attitudes, Practices, and Recommendations for Enhancing Routine HIV Testing and Linkage to Care in the Mississippi Delta Region

2013 ◽  
Vol 27 (9) ◽  
pp. 511-517 ◽  
Author(s):  
Nathan Sison ◽  
Annajane Yolken ◽  
Joanna Poceta ◽  
Leandro Mena ◽  
Philip A. Chan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Healthcare Provider ◽  
Mississippi Delta ◽  
Linkage To Care ◽  
Delta Region ◽  
Provider Attitudes ◽  
Routine Hiv Testing

scholarly journals 1273. Routine Opt-out HIV Screening and Detection of HIV Infection Among Emergency Department Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S388-S388
Author(s):  
Nada Fadul ◽  
Ciarra Dortche ◽  
Richard Baltaro ◽  
Tim Reeder
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Medical Center ◽  
Linkage To Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Opt Out ◽  
Post Test

Abstract Background The Southeastern United States bears a disproportionate burden of HIV infection, accounting for nearly half of all new cases. The Centers for Disease Control and Prevention released routine opt-out testing recommendations in 2006. Our emergency department collaborated with our infectious diseases clinic (ECU-ID) to implement suggested guidelines among adults since March 2017. Methods Our primary aim was to implement routine, opt-out HIV testing in the Vidant Medical Center Emergency Department (ED) for patients between 18 and 65 years of age who have blood work completed, and have not had a test documented in the electronic medical record (EMR) in the last year. A secondary aim was to successfully link HIV-positive patients to care at ECU-ID or preferred clinic. Methods defining programmatic success included developing nurse directed opt-out ordering protocol, integrating testing into normal ED workflow, utilizing the existing EMR to prompt testing, and hiring a linkage coordinator to initiate post-test counseling and linkage-to-care. Results Since March 2, 2017, a total of 7,109 HIV tests were performed; an average of 592 monthly tests conducted compared with a previous average of 10 stat tests. Testing increased 5,820% compared with 2015. Of the 21 HIV-positive patients found, 16 were newly diagnosed. Among those newly diagnosed, 14 (87.5%) were linked to care; and among the five known positives, two (40%) were linked to care. Reasons why patients could not be linked included incarceration, refusal to link to care, and re-location. Conclusion Joined with the implementation of a routinized ED HIV testing program, a seamless process was developed to link persons found to be positive in the ED to HIV care services; therefore, establishing a systems-level prevention model. Future plans include expanding testing to adolescents and utilizing similar methods to integrate Hepatitis C testing. Disclosures All Authors. Gilead Sciences, Inc.: Grant Investigator, Grant recipient and Salary.

scholarly journals Netherlands to introduce routine HIV testing of pregnant women

2003 ◽  
Vol 7 (17) ◽  
Author(s):  
B Blommerde
Keyword(s):  
The Netherlands ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Screening Tests ◽  
Opt Out ◽  
Routine Hiv Testing ◽  
Mother To Child

Beginning in January 2004, screening tests for HIV are to be offered to all pregnant women in the Netherlands on an 'opt-out' basis to prevent transmission of HIV from mother to child.

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