Evaluation of opt-out inpatient HIV screening at an urban teaching hospital Journal Article

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Authors: Osorio, G.; Hoenigl, M.; Quartarolo, J.; Barger, K.; Morris, S. R.; Reed, S. L.; Lee, J; Little, S. J.
Article Title: Evaluation of opt-out inpatient HIV screening at an urban teaching hospital
Abstract: This study evaluated opt-out inpatient HIV screening delivered by admitting physicians, and compared number of HIV tests and diagnoses to signs and symptoms-directed HIV testing (based on physician orders) in the emergency department (ED). The opt-out inpatient HIV screening program was conducted over a one year period in patients who were admitted to the 386-bed University of California San Diego (UCSD) teaching hospital. Numbers of HIV tests and diagnoses were compared to those observed among ED patients who underwent physician-directed HIV testing during the same time period. Survey data were collected from a convenience sample of patients and providers regarding the opt-out testing program. Among 8488 eligible inpatients, opt-out HIV testing was offered to 3017 (36%) patients, and rapid antibody testing was performed in 1389 (16.4%) inpatients, resulting in 6 (0.4% of all tests) newly identified HIV infections (5/6 were admitted through the ED). Among 27,893 ED patients, rapid antibody testing was performed in 88 (0.3%), with 7 (8.0% of all tests) new HIV infections identified. HIV diagnoses in the ED were more likely to be men who have sex with men (MSM) (p = 0.029) and tended to have AIDS-related opportunistic infections (p = 0.103) when compared to HIV diagnoses among inpatients. While 85% of the 150 physicians who completed the survey were aware of the HIV opt-out screening program, 44% of physicians felt that they did not have adequate time to consent patients for the program, and only 30% agreed that a physician is best-suited to consent patients. In conclusion, the yield of opt-out HIV rapid antibody screening in inpatients was comparable to the national HIV prevalence average. However, uptake of screening was markedly limited in this setting where opt-out screening was delivered by physicians during routine care, with limited time resources being the major barrier.
Journal Title: AIDS Care
ISSN: 1360-0451; 0954-0121
Publisher: Unknown  
Journal Place: England
Date Published: 2017
Start Page: 1
End Page: 5
Language: eng
DOI/URL:

10.1080/09540121.2017.1282106
Notes: LR: 20170411; GR: R01 AI057167/AI/NIAID NIH HHS/United States; GR: P50 DA026306/DA/NIDA NIH HHS/United States; GR: R21 AI077304/AI/NIAID NIH HHS/United States; GR: R01 NS051132/NS/NINDS NIH HHS/United States; GR: R01 AI047745/AI/NIAID NIH HHS/United States; GR: R25 MH081482/MH/NIMH NIH HHS/United States; GR: U01 AI027670/AI/NIAID NIH HHS/United States; GR: R21 AI047745/AI/NIAID NIH HHS/United States; GR: R37 AI029164/AI/NIAID NIH HHS/United States; GR: U01 AI069432/AI/NIAID NIH HHS/United States; GR: R21 AI108351/AI/NIAID NIH HHS/United States; GR: U01 AI043638/AI/NIAID NIH HHS/United States; GR: P30 AI036214/AI/NIAID NIH HHS/United States; GR: R01 MH083552/MH/NIMH NIH HHS/United States; GR: P01 AI074621/AI/NIAID NIH HHS/United States; GR: R01 MH100974/MH/NIMH NIH HHS/United States; GR: R24 AI106039/AI/NIAID NIH HHS/United States; JID: 8915313; OTO: NOTNLM; aheadofprint; SO: AIDS Care. 2017 Jan 23:1-5. doi: 10.1080/09540121.2017.1282106.