Methods: Our primary aim was to implement routine, opt-out HIV testing in the Vidant Medical Center Emergency Department (ED) for patients between 18-65 years of age who have blood work completed, and have not had a test documented in the electronic medical record (EMR) in the last year. A secondary aim was to successfully link HIV-positive patients to care at ECU-ID or preferred clinic. Methods defining programmatic success included developing nurse directed opt-out ordering protocol, integrating testing into normal ED workflow, utilizing the existing EMR to prompt testing, and hiring a linkage coordinator to initiate post-test counseling and linkage-to-care.
Results: Since March 2nd, 2017, a total of 7,109 HIV tests were performed; an average of 592 monthly tests conducted compared to a previous average of 10 stat tests. Testing increased 5,820% compared to 2015. Of the 21 HIV-positive patients found, 16 were newly diagnosed. Among those newly diagnosed, 14 (87.5%) were linked to care; and among the 5 known positives, 2 (40%) were linked to care. Reasons why patients could not be linked included incarceration, refusal to link to care, and re-location.
Conclusion: Joined with the implementation of a routinized ED HIV testing program, a seamless process was developed to link persons found to be positive in the ED to HIV care services; therefore, establishing a systems-level prevention model. Future plans include expanding testing to adolescents and utilizing similar methods to integrate Hepatitis C testing.
Gilead Sciences, Inc.:
R. Baltaro, Gilead Sciences, Inc.: Grant Investigator , Grant recipient and Salary .
T. Reeder, Gilead Sciences, Inc.: Grant Investigator , Grant recipient and Salary .