162804 Integration of HIV Testing within Routine Care in a Large Public Hospital System

Tuesday, November 6, 2007: 9:15 AM

Joanna Omi , Corporate Planning and HIV Services, New York City Health and Hospitals Corporation, New York, NY
Terry Hamilton , Corporate Planning and HIV Services, New York City Health and Hospitals Corporation, New York, NY
Judith Aberg, MD , AIDS Clinical Trials Unit, HHC/Bellevue Hospital Center, New York, NY
Issues: In 2005, the largest municipal hospital system in the nation initiated an HIV testing expansion initiative to: 1) increase the number of patients who know their HIV status; 2) identify individuals early in their disease, and 3) retain identified patients in care.

Description: Seventeen hospitals and clinics participated. After training clinicians and staff, facilities: adopted the use of rapid HIV tests; offered HIV testing in outpatient clinics, inpatient care and emergency rooms; integrated testing into routine care, and urged physicians to offer the test.

Lessons Learned: Testing increased by 64% (58,785/92,123). 9.49% of total patients were tested, an increase of 56%. The number of positive patients more than doubled, from 720 in FY05 to 1,514 in FY06. The prevalence of HIV varied across facilities and was 1.64% among all patients tested. 76% of newly positive patients received and kept their first appointment for HIV primary care (589/774).

Recommendations: The use of rapid tests and the integration of testing within routine care can significantly increase the number of positive individuals identified and identify individuals who would otherwise be unaware of their status. The rate of testing acceptance and follow-up appointment compliance may be affected by site of test and the offering process used. Methods used and lessons learned provide significant insight for other health care institutions considering the initiation or expansion of HIV testing.

Learning Objectives:
1. To identify two ways in which HIV testing can be integrated into routine care within inpatient, outpatient and emergency departments. 2. To identify issues that can impact the prevalence of HIV in patients tested by location. 3. To identify three factors that contribute to testing acceptance and patient completion of the first follow-up medical appointment.

Keywords: HIV/AIDS, Access and Services

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.