Online Program

Reaching the hidden HIV epidemic: Effective tools for implementing routine opt-out screening at community health centers

Tuesday, November 3, 2015 : 10:50 a.m. - 11:10 a.m.

Megan Crowley, MPH, Alameda Health Consortium, San Leandro, CA
Sophy Wong, MD, Alameda Health Consortium, San Leandro, CA
Issues: Integrating universal, opt-out HIV screening into primary care settings, such as community health centers, is essential to identifying individuals who have been missed by more traditional testing programs.  In the era of 15 minute clinic visits and productivity pressures, health care providers face the challenge of needing streamlined and effective tools to systematically implement public health and preventive care practices.

Description: Routine opt-out HIV screening was integrated at 4 community health centers, encompassing over 20 sites across a large metropolitan area. Implementation strategies included clinician and staff training, coaching, integration of electronic health record (EHR) tools, and peer learning networks.

Lessons Learned: Findings include clinician and staff training resulting in an average increase of 56% in HIV tests provided per month during the first month, and 75% per month after two months. These gains were most sustained when combined with EHR tools and coaching. Findings also underscored the importance of obtaining leadership buy in from multiple sectors of the community health care system, including administrative leadership, medical directors, IT/EHR teams, as well as the care teams delivering services. During the first year of the project, implementing the above strategies for HIV screening resulted in an overall 107% increase from the previous year in the number of HIV tests provided by participating health centers.

Recommendations: These findings support the notion that clinician and staff training, combined with comprehensive support in the form of EHR tools and coaching, is an effective strategy for increasing HIV testing rates in primary care settings.

Learning Areas:

Chronic disease management and prevention
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
Evaluate tools and strategies for integrating routine, opt-out HIV testing into primary care workflows at community health centers.

Keyword(s): Community Health Centers, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As the Project Manager for a multi-site routine opt-out HIV screening project, I am responsible for overseeing implementation of project activities across sites, as well as analyzing data. I have worked in the HIV/AIDS field since completing my Masters in Public Health degree in 2008. My professional interests include systems transformation, HIV linkage to care, and quality improvement in HIV care settings.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Gilead Sciences HIV screening Part of my salary is funded by a a grant from the Gilead FOCUS HIV testing initiative.

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.

Back to: 4137.0: HIV Testing Strategies