A System-Level Approach to Improve HIV Screening in an Urban Pediatric Primary Care Setting

Area of Science:

• Public Health
• Infectious Disease Prevention
• Adolescent Health

Background:

• Many adolescents living with HIV are unaware of their status, despite recommendations for universal screening.
• Pediatric primary care settings face challenges in testing at-risk youth for HIV.
• Current HIV screening rates among at-risk youth in pediatric primary care are suboptimal.

Purpose of the Study:

• To evaluate the impact of rapid HIV screening implementation on screening rates.
• To assess the effect of rapid HIV screening on HIV test result receipt among youth.
• To improve HIV service delivery to adolescents in primary care settings.

Main Methods:

• A quality improvement initiative using a plan-do-study-act model over four cycles.
• Included 4433 eligible patients aged 13-25 years for HIV screening.
• Logistic regression and statistical process control charts analyzed screening rates and rapid test utilization.

Main Results:

• HIV screening rates increased from a baseline of 29.6% to 82.7% by cycle 4.
• Rapid screening accounted for 90.4% of all HIV tests conducted.
• Same-day result receipt was higher with rapid screening, and five HIV-positive patients were linked to care.

Conclusions:

• Rapid HIV screening, coupled with system modifications, substantially enhanced screening rates and result delivery.
• This intervention proves effective in delivering essential HIV services to youth.
• The study highlights the success of rapid HIV testing in pediatric primary care settings.