Computer-Based Substance Use Reporting and Acceptance of HIV Testing Among Emergency Department Patients.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Behavioral Science

Background:

• Routine human immunodeficiency virus (HIV) testing in emergency departments (ED) is recommended but underutilized.
• Many patients decline initial HIV testing offers, necessitating targeted interventions.
• Understanding factors influencing test acceptance is crucial for improving public health outcomes.

Purpose of the Study:

• To evaluate a video-based intervention aimed at increasing HIV testing acceptance among ED patients who initially declined.
• To determine if demographic concordance with on-screen characters or reported problem substance use influences intervention efficacy.

Main Methods:

• Merged data from three trials conducted in a high-volume New York City ED (N=560).
• Analyzed patient characteristics, including demographics and substance use, in relation to post-intervention HIV testing.
• Employed Chi Square and logistic regression analyses to assess intervention effectiveness.

Main Results:

• Demographic concordance (gender, race) did not significantly impact HIV test acceptance.
• Participants reporting problem substance use were significantly more likely to accept HIV testing post-intervention (36.4%) compared to those without problem substance use (30.5%) or no substance use (28.8%).
• Problem substance use is associated with increased HIV risk behaviors, underscoring the importance of testing in this population.

Conclusions:

• A video-based intervention can increase HIV testing among ED patients who initially decline.
• Problem substance use is a significant predictor of HIV test acceptance in this intervention context.
• Targeting interventions for individuals with problem substance use may improve HIV screening and linkage to care.