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Opportunities for earlier HIV diagnosis in a pediatric ED

Michelle D Eckerle1, Madjimbaye Namde2, Carolyn K Holland3

  • 1Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

The American Journal of Emergency Medicine
|May 27, 2015
PubMed

Insights

Pediatric emergency departments (PEDs) offer missed opportunities for early human immunodeficiency virus (HIV) diagnosis. Implementing HIV screening in PEDs is crucial, but alternative strategies are needed to reach at-risk adolescents.

Area of Science:

  • Public Health
  • Pediatrics
  • Infectious Diseases

Background:

  • Emergency department (ED) human immunodeficiency virus (HIV) screening is recommended but faces implementation challenges and uncertain effectiveness in pediatric EDs (PEDs).
  • Identifying opportunities for earlier HIV diagnosis in young adults within the PED setting is critical for improving health outcomes.

Purpose of the Study:

  • To determine if earlier HIV diagnosis was possible in the PED for young adults diagnosed with HIV.
  • To evaluate the frequency of undiagnosed HIV-positive individuals presenting to PEDs.

Main Methods:

  • Retrospective cohort study of young adults receiving HIV care.
  • Reviewed Pediatric ED records for visits occurring between estimated HIV acquisition and diagnosis.
  • Assessed documentation of HIV suspicion and testing offers.

Main Results:

  • Only 3.6% of HIV-positive young adults were seen in the PED while undiagnosed.
  • No documentation of HIV testing offered, refused, or suspected in these cases.
  • Highlights a low frequency of contact with undiagnosed individuals in PEDs compared to adult EDs.

Conclusions:

  • Opportunities exist for earlier HIV diagnosis in PEDs, supporting the need for screening implementation.
  • PEDs may not be the primary setting for identifying undiagnosed HIV in young adults.
  • Alternative strategies are necessary to effectively reach at-risk adolescent populations for HIV testing and diagnosis.
Abstract

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