496. Factors Affecting the Likelihood of HIV Screening Among High-Risk Patients
Session: Poster Abstract Session: HIV Testing and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
  • IDSA_2011_496.pdf (221.5 kB)
  • Background: Full HIV treatment benefits are not being realized as 21% of the approximately 1.2 million HIV-infected persons in the US are unaware of their disease. In addition to provider/patient factors, organizational barriers impede disease identification and treatment. The study objective is to understand organizational factors in predicting the likelihood of HIV screening in high-risk patients.
    Methods: The study employed a cross-sectional design comparing HIV screening rates with varying resources at the organizational level. The analytic dataset combined: (2) patient data from the Department of Veterans Affairs (VA) Austin Automation Center (AAC); and (2) facility data from VA's 2007 Clinical Practice Organizations Survey (CPOS). AAC provided patient demographic, risk factors, and HIV screening status. CPOS surveyed 225 primary care directors on facility characteristics. We generated scores from factor analyses to describe organizational factors. We used hierarchical generalized linear modeling to estimate likelihood of HIV testing as a function of these factors, controlling for patient demographics, risk factors, and facility clustering effect.

    Results: The study included 49,584 patients from 14 facilities, with 96% being male, 78% <65 years, and 24% minority; 73% earned an income of <$30,000, and 20% were homeless. Patients reported these risk factors: (1) 35% had substance abuse disorder; (2) 25% Hepatitis B; (3) 58% Hepatitis C; and (4) 6% STD. Multivariate results showed that patient factors (e.g., minority status and risk factors) were positively associated with testing. Organizational factors associated with increased likelihood of testing were resource sufficiency in personnel and financial support (p=0.0018), support staff (p=0.0002), space and equipment (p<0.0001), and patient care support (p=0.001). Patients receiving care from facilities supported by national or local resources reported higher likelihood of testing.
    Conclusion: These data indicate that variations in institutional resources contribute to variations in HIV testing rates. To promote and improve HIV screening, our findings showed that health care organizations should consider strategies to achieve resource sufficiency and patient care support.

    Subject Category: H. HIV/AIDS and other retroviruses

    Ann Chou, PhD, MPH, MA1, Elizabeth Yano1, Tuyen Hoang2, Steven Asch3, Allen Gifford4 and Matthew Bidwell Goetz, MD5, (1)VA Greater Los Angeles Health Care System, North Hills, CA, (2)VA West Los Angeles, Los Angeles, CA, (3) VA Greater Los Angeles Healthcare System, Los Angeles, CA, (4)VA Bedford , Bedford, MA, (5)VA Greater Los Angeles Healthcare System, Los Angeles, CA


    A. Chou, None

    E. Yano, None

    T. Hoang, None

    S. Asch, None

    A. Gifford, None

    M. Bidwell Goetz, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.