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Implementing a quality initiative significantly increased human immunodeficiency virus (HIV) screening in an emergency department for cancer patients. This improved early detection and linkage to care for this vulnerable population.

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Area of Science:

  • Oncology
  • Infectious Diseases
  • Public Health

Background:

  • Cancer patients have similar human immunodeficiency virus (HIV) testing rates as the general population (15-40%).
  • Untreated HIV in cancer patients can negatively impact outcomes and increase oncogenic virus transmission.
  • There is a need to improve HIV screening in cancer centers.

Purpose of the Study:

  • To enhance HIV screening rates among cancer patients within the Emergency Department (ED) of a comprehensive cancer center.
  • To evaluate the effectiveness of a quality improvement initiative aimed at increasing HIV testing.

Main Methods:

  • A quality initiative was implemented in the ED of a comprehensive cancer center.
  • HIV testing rates were monitored before and during the intervention period.
  • Data on seropositive rates, incidence, and linkage to care were collected.

Main Results:

  • HIV testing increased significantly from 0.15/day to 2.69/day (p<0.001).
  • The seropositive HIV rate was 1.4% (12/852), with an incidence of 0.3%.
  • All identified patients were successfully linked to care.

Conclusions:

  • A targeted quality initiative can substantially improve HIV screening in the ED setting for cancer patients.
  • Barriers to testing include consent confusion, provider oversight, and linkage concerns.
  • Effective linkage to care was achieved for all newly diagnosed cases.