Early detection and treatment of HIV has been proven to significantly decrease individual morbidity and mortality, as well as reduce transmission of the virus. Increasing rate of HIV testing is the key to early diagnosis. Routine HIV testing has been recommended by CDC for almost a decade. HIV testing in hospitalized patients is crucial as they are considered a high risk group but remains challenging. We hypothesize that the rate of HIV testing in the hospital setting can be increased by re-offering testing to patients who were not initially tested via the hospital’s standard screening protocol at the point of entry of care, in the Emergency Department and during the admission process.
This is a prospective cohort study assessing HIV screening rates amongst patients admitted to the General Internal Medicine service in an urban teaching hospital in New York City. Patients were randomized into two groups on admission day two. The control group consisted of 77 patients who were offered testing per the standard of care by Emergency Department staff and later by the admitting in-patient internal medicine housestaff. The intervention group consisted of 81 patients who were re-offered HIV testing by trained counselors on the second day of admission. Testing rates as well as demographic data such as sex, age and race were compared between the two groups.
A total of 61 tests were performed, 8 in the control group (10.3%), versus 53 in intervention group (65.4%). Patients were significantly more likely to receive an HIV test in the treatment group compared to those in the control group (OR=16.33, 95% CI: 6.88, 38.71, p<0.001). The two groups were comparable in terms of age (p=0.27, t-test), sex (p=0.43, Chi-square test), and race (p=0.16, Fisher’s exact test).
There was a statistically significant higher rate of HIV testing when patients were reoffered testing by trained counselors on the second day of admission as compared to those who were offered testing at the point of entry of care by Emergency Department staff or the admitting team. We believe that both the involvement of the trained counselors and the timing of the offer contributed to the increased rate of HIV testing.
H. Rao, None
L. Ahmadi, None
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