TY - JOUR
T1 - HIV testing in emergency departments in the United States
T2 - A national survey
AU - Haukoos, Jason S.
AU - Hopkins, Emily
AU - Hull, Amber
AU - Dean, Christian
AU - Donahoe, Kevin
AU - Ruzas, Christopher M.
AU - Bauerle, Jessica D.
AU - Terrien, Brian
AU - Forsyth, Jessica
AU - Kalish, Brian
AU - Thrun, Mark
AU - Rothman, Richard
N1 - Funding Information:
Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org ). Supported in part by an Independent Scientist Award (K02 HS017526) from the Agency for Healthcare Research and Quality, a cooperative agreement (U18 PS000314) from the Centers for Disease Control and Prevention, and an unrestricted grant from Abbott Laboratories (Haukoos). The Inaugural National Emergency Department HIV Consortium meeting was supported in part by an unrestricted grant from Gilead Sciences, Inc . Dr. Rothman was funded in part by a grant from the Maryland Department of Health and Mental Hygiene .
Funding Information:
Publication of this article was supported by Centers for Disease Control and Prevention, Atlanta, GA.
PY - 2011/7
Y1 - 2011/7
N2 - Objectives: In 2006, the Centers for Disease Control and Prevention (CDC) published recommendations for HIV testing in health care settings, calling for nontargeted opt-out rapid HIV screening in most settings, including emergency departments (EDs). Although a number of ED-based testing strategies exist, it is unclear to what extent they are used. The objective of this study is to survey academic and community EDs throughout the United States to determine ED-based HIV testing practices. Methods: This was a cross-sectional survey study of all academic EDs and a weighted random sample of all community-based EDs in the United States. A standardized survey instrument was developed and administered with an Internet-based survey platform, followed by direct contact and mail. The survey included domains related to perceived HIV testing barriers, whether HIV testing was performed and methods used, and familiarity with the CDC recommendations and whether they had been adopted. Results: Of the 131 total academic sites and the 435 community sites, 99 (76%) and 150 (35%) completed the survey, respectively. A larger proportion of academic sites believed HIV testing was needed (P=.02) and a larger proportion actually provided HIV testing (65% versus 50%; P=.04). Among the academic and community EDs that provided testing, 74% and 62% performed diagnostic testing, 26% and 22% performed targeted screening, and 16% and 6% performed nontargeted screening, respectively. A larger proportion of academic EDs reported receiving external funding to support testing (23% versus 4%; P=.001), whereas a large proportion of community sites considered costs a significant barrier to testing (P=.03). A larger proportion of academic EDs reported being familiar with the 2006 CDC recommendations (64% versus 40%; P<.001), although only 26% and 37% reported having implemented any part of them, respectively. Conclusion: Academic EDs only make up approximately 3% of all EDs in the United States. Significant differences exist between academic and community EDs as they relate to performing HIV testing. Increased efforts should be made to improve the ability of community EDs to provide this service.
AB - Objectives: In 2006, the Centers for Disease Control and Prevention (CDC) published recommendations for HIV testing in health care settings, calling for nontargeted opt-out rapid HIV screening in most settings, including emergency departments (EDs). Although a number of ED-based testing strategies exist, it is unclear to what extent they are used. The objective of this study is to survey academic and community EDs throughout the United States to determine ED-based HIV testing practices. Methods: This was a cross-sectional survey study of all academic EDs and a weighted random sample of all community-based EDs in the United States. A standardized survey instrument was developed and administered with an Internet-based survey platform, followed by direct contact and mail. The survey included domains related to perceived HIV testing barriers, whether HIV testing was performed and methods used, and familiarity with the CDC recommendations and whether they had been adopted. Results: Of the 131 total academic sites and the 435 community sites, 99 (76%) and 150 (35%) completed the survey, respectively. A larger proportion of academic sites believed HIV testing was needed (P=.02) and a larger proportion actually provided HIV testing (65% versus 50%; P=.04). Among the academic and community EDs that provided testing, 74% and 62% performed diagnostic testing, 26% and 22% performed targeted screening, and 16% and 6% performed nontargeted screening, respectively. A larger proportion of academic EDs reported receiving external funding to support testing (23% versus 4%; P=.001), whereas a large proportion of community sites considered costs a significant barrier to testing (P=.03). A larger proportion of academic EDs reported being familiar with the 2006 CDC recommendations (64% versus 40%; P<.001), although only 26% and 37% reported having implemented any part of them, respectively. Conclusion: Academic EDs only make up approximately 3% of all EDs in the United States. Significant differences exist between academic and community EDs as they relate to performing HIV testing. Increased efforts should be made to improve the ability of community EDs to provide this service.
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U2 - 10.1016/j.annemergmed.2011.03.033
DO - 10.1016/j.annemergmed.2011.03.033
M3 - Article
C2 - 21684387
AN - SCOPUS:79959409241
SN - 0196-0644
VL - 58
SP - S10-S16
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 1 SUPPL.
ER -