The 130th Annual Meeting of APHA

Abstract #42718

Abigail Silva, MPH¹, Nancy Glick, MD², Dyanna Charles, BA², Steven Whitman, PhD¹, and Leslie Zun, MD, MBA³. (1) Sinai Health System, Sinai Urban Health Institute, California at 15th Street, K439, Chicago, IL 60608, 773-257-5785, sila@sinai.org, (2) Department of Medicine, Mount Sinai Hospital, California Avenue at 15th Street, Chicago, IL 60608, (3) Department of Emergency Medicine, Mount Sinai Hospital, 15th and California, Chicago, IL 60608

Background: Mount Sinai Hospital is an urban hospital located in an area where AIDS incidence and HIV mortality rates are higher than the rest of city. Despite the availability of antiretroviral therapies, patients continually present with advanced AIDS who were previously unaware of their HIV serostatus. Therefore we conducted a 12-month pilot project in which we screened high-risk patients for HIV in the ED.

Methods: We offered standard HIV testing to high-risk patients. Among these were those who had an STD, possible opportunistic infection, alcohol or drug abuse, were pregnant or engaged in unprotected sex. Those who were positive were referred for care and those negative received prevention counseling.

Results: During the first 11 months of the project we found an HIV prevalence rate of 2.7% (14/514). Men experienced a slightly higher rate than women (3.3% versus 2.3%) and African-Americans a much higher rate than Hispanics (3.6% versus 0.8%). Those reporting multiple (2+) risks had a significantly higher HIV rate than those with less risks (5.8% versus 1.6%). The primary predictors of HIV infection were alcohol abuse, drug abuse, or an opportunistic infection.

Conclusions: Recently, CDC proposed the “SAFE” strategy for fighting the HIV epidemic. The main component of this strategy involves increasing the number of people who are aware of their serostatus. One recommendation is to offer HIV testing in underutilized venues, such as EDs. This project may be seen as a pilot study for that strategy and the results offer suggestions for future pursuits.

Learning Objectives:

• Explain the new SAFE strategy developed by CDC;
• Articulate how HIV testing in Emergency Departments fits into the SAFE strategy;
• Assess the findings of this study, in particular the HIV seroprevalence rate;
• Discuss to what extent these findings are consistent with the SAFE strategy.

Keywords: HIV/AIDS, Screening

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.