 |
|
Identifying Undiagnosed Human Immunodeficiency Virus
The Yield of Routine, Voluntary Inpatient Testing
Rochelle P. Walensky, MD, MPH;
Elena Losina, PhD;
Kathleen A. Steger-Craven, RN, MPH;
Kenneth A. Freedberg, MD, MSc
Arch Intern Med. 2002;162:887-892.
Background Despite current recommendations for human immunodeficiency virus (HIV) counseling and testing among patients admitted to hospitals with at least a 1% prevalence of HIV infection, an estimated 300 000 people in the United States remain unaware of their HIV infection.
Methods We implemented the Think HIV program, which offered voluntary HIV counseling and testing to patients admitted to the medical service of a Boston, Mass, teaching hospital. We compared the results of this effort with testing results from a 15-month historical control period.
Results Patients admitted during the program period were 3.4 times more likely to undergo testing for HIV than those admitted during the control period (95% confidence interval [CI], 2.8-4.1). The testing program detected approximately 2 new diagnoses of HIV infection per month, compared with 1 per month during the control period. Patients who underwent testing during the program, and who likely would not have done so without this initiative, had an estimated prevalence of HIV infection of 3.8% (95% CI, 1.8%-5.8%).
Conclusions Testing efforts for HIV targeted to only symptomatic patients are inadequate to identify the one third of HIV-seropositive people in the United States who are unaware of their infection. We have shown that in a single urban hospital, offering voluntary, routine inpatient HIV counseling and testing can be successful as a screening program by identifying a substantial number of patients with undiagnosed HIV. These patients then can be informed, counseled, and linked to care and treatment. Seventy-two hospitals nationwide have demographics similar to those of the study hospital, suggesting that these results are generalizable to many urban hospitals.
From the Divisions of Infectious Disease and General Medicine and the Partners AIDS Research Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School (Drs Walensky and Freedberg), the Departments of Epidemiology and Biostatistics (Drs Losina and Freedberg) and Health Services (Ms Steger-Craven), Boston University School of Public Health, and the Department of Medicine, Boston Medical Center (Ms Steger-Craven), Boston, Mass.
RELATED LETTER
Routine HIV Testing Among Inpatients
Curt G. Beckwith, Michelle A. Lally, Timothy P. Flanigan, Rochelle P. Walensky, Elena Losina, and Kenneth A. Freedberg
Arch Intern Med. 2002;162(19):2252-2253.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2002;162(8):951-952.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Screening for HIV: Recommendation Statement
U.S. Preventive Services Task Force*
ANN INTERN MED 2005;143:32-37.
ABSTRACT
| FULL TEXT
Screening for HIV: A Review of the Evidence for the U.S. Preventive Services Task Force
Chou et al.
ANN INTERN MED 2005;143:55-73.
ABSTRACT
| FULL TEXT
Cost-Effectiveness of Screening for HIV
Taiwo et al.
NEJM 2005;352:2137-2139.
FULL TEXT
Routine HIV Testing Among Inpatients
Beckwith et al.
Arch Intern Med 2002;162:2252-2253.
FULL TEXT
Contact Vaccinia--Transmission of Vaccinia From Smallpox Vaccination
Neff et al.
JAMA 2002;288:1901-1905.
FULL TEXT
|
