Poster Abstract Session: HIV Testing and Diagnosis
Thursday, October 27, 2016
Room: Poster Hall
Implementation of CDCs 2006 HIV testing recommendations for routine, nontargeted screening in emergency department (ED) settings has proven challenging. Nonetheless, there may be more focused populations, such as patients tested for sexually transmitted diseases (STD), where routine screening might be attainable. We aimed to assess the extent to which HIV screening was being performed in patients who were tested for STDs.
We performed a retrospective database inquiry of age-eligible adults during the calendar year 2015 at a large academic ED with an established HIV screening program. We determined the frequency at which ED patients who received a gonorrhea and/or chlamydia test also were screened for HIV.
In 2015, there were 54,070 patients between 18 and 65 years old. Out of these age-eligible patients, 1,806 (3.3%) were tested for STDs and 2,256 (4.2%) were tested for HIV either in the ED or at some point during their hospital stay. Out of the 3.34% (1,806) tested for STDs during the study period, 17.1% were tested for HIV. Among all patients who had an STD test done, HIV testing was more frequent in men (25.6%) than women (13.8%).
While the rate of HIV testing was higher in patients who were tested for STDs (17.1%) than in the general ED (4.2%), the absolute frequency of 17% is still very low. This identifies, at least at our institution, a specific ED population where improved testing efforts might be targeted. Because our ED both is an academic center and already had a pre-established HIV screening program, our HIV testing rates are likely higher than the HIV testing rates of community hospitals that do not have well-established HIV testing programs. Further programmatic work and evaluation might be directed at either provider education within this sub-topic or developing implementation strategies to automate linked HIV testing when a gonorrhea and/or chlamydia test is ordered.