160612 Implementation of the revised CDC HIV testing recommendations: Ensuring sustainability and routinization of rapid testing in a hospital-wide system

Tuesday, November 6, 2007: 8:50 AM

Erika Aaron, MSN, CRNP , Div. Infectious Diseases and HIV, Drexel University College of Medicine, Philadelphia, PA
Shannon M. Criniti, MPH , Div. Infectious Diseases and HIV, Drexel University College of Medicine, Philadelphia, PA
Issues: The CDC recommended integrating opt-out HIV screening into routine clinical care in all health care settings (Sept 2006). Implementation of these recommendations needs further exploration, including models of care that adapt to specific clinical settings. Description: At a single hospital, rapid HIV testing was employed in various affiliated settings using site-specific implementation models: delivery room (DR) (2002); FP/OB/GYN clinic (2003); partner-testing in an HIV practice (2004); and emergency department (ED) (2007). Lessons Learned: Screening models need to be site-specific. In the DR, OB residents screened with serum HIV rapid tests, processed in the hospital lab, with results returned within one hour. Seropositivity rate was 0.8%. In the FP/OB/GYN clinic, a dedicated HIV counselor performed the rapid HIV point of care test using oral swab. Testing responsibilities transitioned to permanent clinic staff after three years. Of >2,400 tests, seropositivity rate was 0.9% (7.8% for walk-ins). The HIV clinic utilized clinic staff to test partners with HIV rapid point of care testing in 2004. In the ED, dedicated HIV counselors were embedded Feb 2007. A capacity-building plan has been implemented to transition testing to permanent staff in two years. Future plans are to establish rapid HIV testing in all hospital-affiliated inpatient and outpatient settings. Recommendations: Capacity building, integration and buy-in of staff is essential in the initial planning phase of implementation of the CDC revised testing guidelines. This session will explore different implementation models that were adapted for specific settings to ensure sustainability.

Learning Objectives:
1. Describe at least two different HIV screening models for medical settings. 2. Name at least three components of successful capacity-building to integrate HIV screening programs into medical settings.

Keywords: HIV/AIDS, Practice Guidelines

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.