Routine Inpatient Human Immunodeficiency Virus Screening: Missed Prevention Opportunities

This article reviews the current guidelines for human immunodeficiency virus (HIV) screening among inpatients and explores adherence to the guidelines and barriers to their implementation.

In 2006, the Centers for Disease Control and Prevention released updated recommendations suggesting HIV screening for all patients in all healthcare settings.

A nonsystematic review of current HIV screening guidelines, as well as research and nonresearch literature, addressing rates of inpatient screening was performed.

Between 2000 and 2010, there was a significant increase in testing in healthcare settings. Despite these advances, 10 years after the updated Centers for Disease Control and Prevention guidelines were released, many hospitals still have not fully implemented the recommendations. Barriers to implementation of the guidelines include provider misconceptions and lack of time and reimbursement.

Screening for HIV identifies new infections, reduces transmission, prevents complications, and encourages a discussion about prevention. Increasing adherence to screening recommendations can help prevent new cases and disease progression. The nursing focus on prevention makes clinical nurse specialists and other advanced practice registered nurses uniquely positioned to increase screening. Clinical nurse specialists should implement research projects to understand adherence in their facilities and identify and address site-specific barriers. Quality improvement programs can then be implemented to improve screening rates.