Identifying Out-of-Care, Known HIV+ Patients with a 4th Generation HIV Testing Platform
We conducted a retrospective review of the HIV testing program 15 months before and after converting from a weekday-only, 8am-11pm point-of-care testing procedure to a 7/24 lab-based 4th generation program (4/2012-9/2014). Patients who did not self-report a history of HIV were tested. Patients with positive tests were categorized as previously undiagnosed or known HIV+. An HIV specialist offered linkage to care to any out-of-care, known HIV+ patients.
The number of known HIV+ individuals identified in the ED increased from 341 before the 4th generation testing to 551 in the 15 months after. The expanded test hours (from 11pm-8am) was the main contributor to the increased numbers. Out-of-care, known HIV+ patients were more likely to be identified through the testing mechanism than the self-disclosure route (50% vs. 22%, p<0.001) and 40% of these patients attended at least one HIV-specific outpatient clinic visit. Among the tested individuals, the mean age was 43.5 years, 87% male, 32% were African-American and 48% Latino.
4th Generation testing increased the likelihood of identifying out-of-care, known HIV+ patients in an ED setting. Although re-establishing care among this cohort remains challenging, the testing algorithm allows the re-identification of these patients and possibly linkage to care.
Learning Areas:Chronic disease management and prevention
Public health or related research
Social and behavioral sciences
Evaluate the impact of a 4th generation emergency department HIV screening program on the identification of out-of-care, known HIV+ patients.
Keyword(s): HIV/AIDS, Accessibility
Qualified on the content I am responsible for because: I have been the research project manager and data analyst on this HIV program for the past three years. I received my master of public health training focusing on epidemiology and biostatistics. I am currently in a PhD program emphasizing on human behavior research.
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.