208593 Routine, Opt-Out HIV Screening: A Houston Perspective on the CDC Recommendation

Wednesday, November 11, 2009: 11:00 AM

Marlene L. McNeese-Ward , Bureau of HIV/STD and Viral Hepatitis Prevention, Houston Department of Health and Human Services, Houston, TX
Beau J. Mitts, MPH , Bureau of HIV/STD and Viral Hepatitis Prevention, Houston Department of Health and Human Services, Houston, TX
Issue: In 2006, CDC recommended opt-out, HIV screening be done routinely in health care settings to identify the 25% of individuals living with HIV who do not know their status, subsequently diagnosing individuals earlier in their HIV infection. It is estimated that approximately 5,000 individuals are living with HIV in Houston/Harris County who do not know it. Description: In 2008, a routine, opt-out HIV screening project was implemented in two Level I emergency departments in Houston. These emergency facilities conduct HIV screening 24 hours a day/seven days a week through traditional methodology rather than rapid HIV tests. Laboratory processes have been modified to provide a “rapid” result without a rapid HIV test kit. Lessons Learned: Since implementation, this project has screened nearly 18,000 individuals for HIV. All facilities have advocates of the project, which is a critical component of success. Of those tested, a 0.07% positivity rate has been maintained identifying nearly 130 individuals newly diagnosed with HIV. The opt-out rate has been lower than anticipated – 3% to 5% of those informed of the HIV testing process. Recommendations: This project is unique from other models across the country because Texas law allows for routine, opt-out HIV screening with a general medical consent. HIV screening has been well received by medical providers and the community. The project is currently exploring expansion into two additional emergency departments and four additional community health centers. Routine, opt-out HIV screening should be implemented as a primary HIV prevention tactic in urban epicenters of HIV prevalence.

Learning Objectives:
Identify three challenges and opportunities presented by implementing routine, opt-out HIV screening in emergency departments.

Keywords: HIV/AIDS, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have over 10 years of experience in the HIV/AIDS field and have served as the Bureau Chief of the HIV/STD and Viral Hepatitis Prevention for the City of Houston Department of Health and Human Services for more than three years.
Any relevant financial relationships? No

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.

See more of: Contemporary Issues in HIV Testing
See more of: HIV/AIDS