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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings

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Published on: March 30, 2014

2009 US emergency department HIV testing practices.

Richard E Rothman¹, Yu-Hsiang Hsieh, Leah Harvey

¹Department of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21209, USA. rrothma1@jhmi.edu

Annals of Emergency Medicine

|June 21, 2011

Summary

HIV testing in US emergency departments (EDs) has increased since 2006. While many EDs offer HIV testing, systematic programs remain uncommon, highlighting the need for continued surveillance of these vital public health initiatives.

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Area of Science:

Public Health
Infectious Disease Epidemiology
Healthcare Management

Background:

Emergency departments (EDs) are critical access points for healthcare.
HIV testing in EDs can identify undiagnosed infections and facilitate early treatment.
The Centers for Disease Control and Prevention (CDC) released updated HIV testing recommendations in 2006.

Purpose of the Study:

To characterize the landscape of HIV testing practices and systematic HIV testing programs in US EDs in 2009.
To understand the operational aspects and reach of HIV testing initiatives within emergency care settings.

Main Methods:

A national web-based survey was distributed to members of the National ED HIV Testing Consortium, CDC workshop participants, academic EDs, and a sample of community EDs.
Data collection focused on geographic location, HIV seroprevalence, testing indications, consent methods, testing volume, funding, and costs.

Main Results:

Out of 619 surveyed sites, 338 (54.6%) responded, with 277 (82.0%) reporting any HIV testing.
Only 75 (22.2%) had systematic HIV testing programs, concentrated in the Northeast, urban, high-prevalence areas.
Universal screening was common, and HIV positivity rates exceeded the CDC threshold of 0.1%.

Conclusions:

The number of EDs conducting HIV testing has significantly increased following the 2006 CDC recommendations.
Despite growth, systematic HIV testing programs are not yet widespread in US EDs.
Continued surveillance is essential to monitor the expansion of ED-based HIV testing and identify barriers to implementation.