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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3242.0: Monday, December 12, 2005 - Board 8

Abstract #109479

Emergency department-based HIV testing: Facilitators and barriers

Gretchen W. Torres, MPP1, Romana Hasnain-Wynia, PhD1, Heidi Whitmore, MPP1, Jeremy Pickreign, MS2, and Jennifer K. Stanger1. (1) Health Research and Educational Trust, One North Franklin, 30th floor, Chicago, IL 60606, 312-422-2638, gtorres@aha.org, (2) AHA-Health Research and Educational Trust, 325 7th Street N.W, Washington, DC 20004

Background: Emergency department (ED) based HIV testing is a promising strategy to detect unidentified HIV infections. We aim to identify facilitators and barriers to rapid HIV testing and routine HIV screening in EDs.

Methods: Survey of non-federal, short-term general medical facilities contained in the AHA's database of healthcare providers (n=4,497). 1,230 hospitals responded (27.4%). Data were weighted to adjust for non-response; a finite population correction was applied to standard error estimates.

Results: Ninety-four percent of hospitals with EDs reported that HIV tests can be conducted 24 hours in their EDs. Few hospitals reported they routinely screen for HIV in their EDs (1.6%). 54.5% of hospitals prohibit ED-based screening.

Privacy/confidentiality was a “very important” consideration in deciding whether to implement screening in the ED (79.8%). Staff time was “very important” for 67.8%. Considerations regarding cost/reimbursement, cost-effectiveness, quality assurance and staff time were important for at least 84% of respondents.

In implementing rapid testing, laboratory support and staff training/expertise were “very important” factors for 70%. Funding was an important factor for 68.9% of hospitals not planning to implement rapid testing vs. 54.7% of those using or planning rapid testing. 65.1% identified counseling as a "very important " concern vs. 57% of those using or planning to use.

Conclusions: Most EDs do not perform routine HIV screening; over half prohibit it. Major barriers include hospitals' concerns for privacy/confidentiality. Issues concerning staffing, procedures, and funding are important considerations for screening. Laboratory buy-in, staff training, funding, and counseling are critical to rapid HIV testing implementation.

Learning Objectives: At the conclusion of the session, participants should be able to

Keywords: HIV/AIDS, Emergency Department/Room

Related Web page: www.hret.org/hret/programs/hiv.html

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Current Issues in HIV Counseling and Testing

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA