Rapid HIV testing in a southeastern emergency department serving a semiurban-semirural adolescent and adult population

Richard W. Sattin, James A Wilde, Arin E. Freeman, Kelly M. Miller, James K. Dias

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: We determine the feasibility and yield of universal opt-out HIV screening among adolescents and adults in a southeastern emergency department (ED) serving a semiurban-semirural population. Methods: Individuals aged 13 to 64 years who visited the ED during specified hours received the OraQuick rapid HIV test (administered by trained counselors) if they did not opt out. Western blot was used to confirm reactive results. Patients were excluded if they had a history of HIV, had been tested within the past year, were physically or mentally incapacitated, did not understand their right to opt out, or did not speak English or Spanish. Basic demographic information was analyzed by using standard descriptive statistics. Measures of diagnostic test performance were calculated for all valid tests. Results: From March 2008 through August 2009, 91% (n=8,493) of eligible patients accepted testing, and results were valid. Of 41 reactive results, 35 were confirmed HIV positive, 2 were indeterminate by Western blot, and 4 were false positive. Blacks accounted for the largest percentage (0.65%) of newly detected infections, and the percentage among black men (1%) was more than twice the percentage among black women (0.42%). Rapid-test specificity was estimated at 99.95% (95% confidence interval 99.88% to 99.98%). Nearly 75% of patients confirmed as HIV positive kept their first HIV clinic appointment. Conclusion: High rates of acceptance of testing in an ED and linkage to HIV care for adolescents and adults with newly detected infection can be achieved by using opt-out testing and trained HIV counselors.

Original languageEnglish (US)
JournalAnnals of Emergency Medicine
Volume58
Issue number1 SUPPL.
DOIs
StatePublished - Jul 1 2011

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Hospital Emergency Service
HIV
Population
Western Blotting
HIV-2
Infection
Routine Diagnostic Tests
Appointments and Schedules
Demography
Confidence Intervals

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Rapid HIV testing in a southeastern emergency department serving a semiurban-semirural adolescent and adult population. / Sattin, Richard W.; Wilde, James A; Freeman, Arin E.; Miller, Kelly M.; Dias, James K.

In: Annals of Emergency Medicine, Vol. 58, No. 1 SUPPL., 01.07.2011.

Research output: Contribution to journalArticle

Sattin, Richard W. ; Wilde, James A ; Freeman, Arin E. ; Miller, Kelly M. ; Dias, James K. / Rapid HIV testing in a southeastern emergency department serving a semiurban-semirural adolescent and adult population. In: Annals of Emergency Medicine. 2011 ; Vol. 58, No. 1 SUPPL.
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