TY - JOUR
T1 - Rapid HIV testing in a southeastern emergency department serving a semiurban-semirural adolescent and adult population
AU - Sattin, Richard W.
AU - Wilde, James A.
AU - Freeman, Arin E.
AU - Miller, Kelly M.
AU - Dias, James K.
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 ). Funded by the Georgia Department of Human Resources , contract 427-93-009090681-99, through Centers for Disease Control and Prevention grant 1U62PS000789-01 .
Funding Information:
Publication of this article was supported by Centers for Disease Control and Prevention, Atlanta, GA.
PY - 2011/7
Y1 - 2011/7
N2 - Objective: We determine the feasibility and yield of universal opt-out HIV screening among adolescents and adults in a southeastern emergency department (ED) serving a semiurban-semirural population. Methods: Individuals aged 13 to 64 years who visited the ED during specified hours received the OraQuick rapid HIV test (administered by trained counselors) if they did not opt out. Western blot was used to confirm reactive results. Patients were excluded if they had a history of HIV, had been tested within the past year, were physically or mentally incapacitated, did not understand their right to opt out, or did not speak English or Spanish. Basic demographic information was analyzed by using standard descriptive statistics. Measures of diagnostic test performance were calculated for all valid tests. Results: From March 2008 through August 2009, 91% (n=8,493) of eligible patients accepted testing, and results were valid. Of 41 reactive results, 35 were confirmed HIV positive, 2 were indeterminate by Western blot, and 4 were false positive. Blacks accounted for the largest percentage (0.65%) of newly detected infections, and the percentage among black men (1%) was more than twice the percentage among black women (0.42%). Rapid-test specificity was estimated at 99.95% (95% confidence interval 99.88% to 99.98%). Nearly 75% of patients confirmed as HIV positive kept their first HIV clinic appointment. Conclusion: High rates of acceptance of testing in an ED and linkage to HIV care for adolescents and adults with newly detected infection can be achieved by using opt-out testing and trained HIV counselors.
AB - Objective: We determine the feasibility and yield of universal opt-out HIV screening among adolescents and adults in a southeastern emergency department (ED) serving a semiurban-semirural population. Methods: Individuals aged 13 to 64 years who visited the ED during specified hours received the OraQuick rapid HIV test (administered by trained counselors) if they did not opt out. Western blot was used to confirm reactive results. Patients were excluded if they had a history of HIV, had been tested within the past year, were physically or mentally incapacitated, did not understand their right to opt out, or did not speak English or Spanish. Basic demographic information was analyzed by using standard descriptive statistics. Measures of diagnostic test performance were calculated for all valid tests. Results: From March 2008 through August 2009, 91% (n=8,493) of eligible patients accepted testing, and results were valid. Of 41 reactive results, 35 were confirmed HIV positive, 2 were indeterminate by Western blot, and 4 were false positive. Blacks accounted for the largest percentage (0.65%) of newly detected infections, and the percentage among black men (1%) was more than twice the percentage among black women (0.42%). Rapid-test specificity was estimated at 99.95% (95% confidence interval 99.88% to 99.98%). Nearly 75% of patients confirmed as HIV positive kept their first HIV clinic appointment. Conclusion: High rates of acceptance of testing in an ED and linkage to HIV care for adolescents and adults with newly detected infection can be achieved by using opt-out testing and trained HIV counselors.
UR - http://www.scopus.com/inward/record.url?scp=79959439483&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79959439483&partnerID=8YFLogxK
U2 - 10.1016/j.annemergmed.2011.03.026
DO - 10.1016/j.annemergmed.2011.03.026
M3 - Article
C2 - 21684410
AN - SCOPUS:79959439483
SN - 0196-0644
VL - 58
SP - S60-S64
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 1 SUPPL.
ER -