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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
Published on: October 31, 2010
A targeted, conventional assay, emergency department HIV testing program integrated with existing clinical procedures
Stephen J Schrantz1, Christine A Babcock, Christian Theodosis
1Section of Infectious Diseases, Department of Medicine, Division of Infectious Diseases, University of Chicago Medical Center, Chicago, IL 60201, USA. sschrantz@northshore.org
Annals of Emergency Medicine
|June 21, 2011
Summary
This clinical HIV testing program in an emergency department identified new HIV cases and linked them to care using standard assays and hospital staff. The model is widely implementable without needing external funding or rapid testing.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Clinical Medicine
Background:
- Widespread implementation of HIV testing models has been limited.
- Conventional assays, hospital personnel, and electronic systems can facilitate HIV testing programs.
Purpose of the Study:
- To describe a clinical HIV testing program utilizing conventional assays and hospital personnel.
- To evaluate the program's effectiveness in identifying new HIV cases and linking them to care.
Main Methods:
- Review of clinical HIV testing program records and hospital emergency department (ED) and laboratory records from January 2007 to November 2008.
- Analysis of HIV testing rates, positivity, result notification, new diagnoses, linkage to care, and baseline CD4 counts.
Main Results:
- 1,258 (1.2%) of 103,475 ED visits resulted in HIV testing, with 54 (4.3%) positive for HIV antibody.
- 28 (2.2%) individuals received a new diagnosis, with 89% linked to care.
- Mean baseline CD4 count for new diagnoses was 180 cells/μL.
Conclusions:
- The described ED HIV testing model effectively increased new patient identification, result notification, and linkage to care.
- The model is widely implementable without external funding for parallel staffing or rapid assays.
- While not meeting all CDC recommendations, the program demonstrates a feasible approach to expanding HIV testing.
