Routine HIV testing within the emergency department of a major trauma centre: a pilot study.

Area of Science:

• Public Health
• Infectious Diseases
• Clinical Medicine

Background:

• UK guidelines advocate for routine Human Immunodeficiency Virus (HIV) testing in medical admissions when local prevalence exceeds 2 per 1000.
• Emergency departments (EDs) in major trauma centers are critical points for identifying undiagnosed HIV infections.

Purpose of the Study:

• To evaluate the uptake and impact of routine HIV testing in a major trauma center's ED during a 3-month pilot study.
• To assess the feasibility and staff acceptability of implementing widespread HIV screening in the ED setting.

Main Methods:

• Routine HIV testing was offered to ED attendees undergoing blood tests.
• Uptake was measured by the proportion of patients with full blood counts (FBCs) who were tested for HIV.
• Newly diagnosed patients were linked to care, and contact tracing was initiated.
• Staff perceptions of routine HIV testing were assessed via an anonymous online survey.

Main Results:

• A total of 2828 patients were tested, identifying 19 individuals with HIV.
• Eight new HIV diagnoses were made, with two suspected seroconversions.
• The prevalence of new diagnoses was 0.28%, compared to the local PHE prevalence of 0.625%.
• HIV testing uptake reached 30%, a significant increase from the preceding 2 months (P < 0.001).
• Ninety-five percent of surveyed staff supported permanent rollout of routine ED HIV testing.

Conclusions:

• Routine HIV testing in the ED successfully identified new HIV diagnoses and individuals lost to care.
• The pilot demonstrated high staff acceptance and provided data supporting the implementation of ongoing HIV screening in EDs.
• The study's findings were instrumental in securing funding for sustained routine HIV testing in the ED.