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APHA Scientific Session and Event Listing

Laura Bogart, PhD¹, James Lange, PhD², Devery Howerton, PhD², Kirsten Becker, MPH³, Allen Gifford, MD⁴, Claude Messan Setodji, PhD¹, and Steven Asch, MD⁵. (1) Health Program, RAND Corporation, 1776 Main St. P.O. Box 2138, Santa Monica, CA 90407-2138, 310-393-0411x7109, lbogart@rand.org, (2) Laboratory Practice Evaluation and Genomics Branch, Laboratory Systems Division, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Coordinating Center for Infectious Diseases, 4770 Buford Highway MS-G23, Atlanta, GA 30341-3717, (3) Survey Research Group, RAND Corporation, 1776 Main St. P.O. Box 2138, Santa Monica, CA 90407-2138, (4) VA QUERI-HIV Coordinating Center, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, (5) Department of General Internal Medicine, Greater Los Angeles VA Healthcare System, 11301 Wilshire Blvd., Bldg. 500 - Room 3244, Mailstop: 111-G, Los Angeles, CA 90073

Background: Rapid HIV tests offer advantages over traditional testing in acute care settings, including rapid provision of results at the point of service. However, little is known about the diffusion of rapid tests across U.S. hospitals. The present study examined the scope of rapid HIV test use in a national random sample of hospitals.

Methods: In a two-step sampling frame, 12 primary metropolitan statistical areas (PMSAs; 3 per U.S. region) were sampled randomly, with sampling weights proportional to AIDS populations; and all eligible non-rehabilitation hospitals (n = 671) within the PMSAs were selected. Laboratory staff at 570 hospitals (85%) were interviewed by telephone in 2005.

Results: 53% (n=299) reported current rapid HIV test use. Of the 271 hospitals not using rapid tests, 63 (24%) had concrete plans to start. Nearly half of hospitals were using rapid HIV tests for occupational health purposes, 27% in labor and delivery, and 13% in the emergency department/urgent care. Almost half (45%) processed rapid tests in the laboratory rather than at the point of service. In multivariate models, hospitals in areas of higher AIDS prevalence, in the Midwest (vs. California), and with more staff, more births, and a stronger community orientation were significantly more likely to be using rapid tests.

Conclusions: Rapid HIV testing is increasing across U.S. hospitals, but is primarily used after occupational exposure. Policies should be developed to encourage greater breadth of diffusion of rapid HIV testing of patients within hospital settings, especially in smaller hospitals and at the point of service.

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

• Estimate the prevalence of rapid HIV testing in U.S. hospitals
• Discuss the implications of rapid test diffusion in hospitals for HIV screening in the U.S.

Keywords: HIV/AIDS, Screening

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 109.0 kb)