Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109479

Gretchen W. Torres, MPP¹, Romana Hasnain-Wynia, PhD¹, Heidi Whitmore, MPP¹, Jeremy Pickreign, MS², and Jennifer K. Stanger¹. (1) Health Research and Educational Trust, One North Franklin, 30th floor, Chicago, IL 60606, 312-422-2638, gtorres@aha.org, (2) AHA-Health Research and Educational Trust, 325 7th Street N.W, Washington, DC 20004

Background: Emergency department (ED) based HIV testing is a promising strategy to detect unidentified HIV infections. We aim to identify facilitators and barriers to rapid HIV testing and routine HIV screening in EDs.

Methods: Survey of non-federal, short-term general medical facilities contained in the AHA's database of healthcare providers (n=4,497). 1,230 hospitals responded (27.4%). Data were weighted to adjust for non-response; a finite population correction was applied to standard error estimates.

Results: Ninety-four percent of hospitals with EDs reported that HIV tests can be conducted 24 hours in their EDs. Few hospitals reported they routinely screen for HIV in their EDs (1.6%). 54.5% of hospitals prohibit ED-based screening.

Privacy/confidentiality was a “very important” consideration in deciding whether to implement screening in the ED (79.8%). Staff time was “very important” for 67.8%. Considerations regarding cost/reimbursement, cost-effectiveness, quality assurance and staff time were important for at least 84% of respondents.

In implementing rapid testing, laboratory support and staff training/expertise were “very important” factors for 70%. Funding was an important factor for 68.9% of hospitals not planning to implement rapid testing vs. 54.7% of those using or planning rapid testing. 65.1% identified counseling as a "very important " concern vs. 57% of those using or planning to use.

Conclusions: Most EDs do not perform routine HIV screening; over half prohibit it. Major barriers include hospitals' concerns for privacy/confidentiality. Issues concerning staffing, procedures, and funding are important considerations for screening. Laboratory buy-in, staff training, funding, and counseling are critical to rapid HIV testing implementation.

Learning Objectives: At the conclusion of the session, participants should be able to

• List 2 concerns identified by hospitals as very important considerations in deciding whether to implement HIV screening in their emergency departments (EDs).
• List 2 factors cited by hospitals as very important in deciding whether to implement rapid HIV testing in their hospital.
• Discuss differences in perceived barriers by hospitals currently practicing rapid HIV testing versus hospitals not planning to implement rapid HIV testing.

Keywords: HIV/AIDS, Emergency Department/Room

Related Web page: www.hret.org/hret/programs/hiv.html

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.