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

Osorio, Georgina; Hoenigl, Martin; Quartarolo, Jennifer; Barger, Khamisah; Morris, Sheldon R.; Reed, Sharon L.; Lee, Joshua

doi:10.1080/09540121.2017.1282106

Cited by 16 publications

(17 citation statements)

References 13 publications

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“…Both community-based HIV screening programs and routine testing in EDs may therefore have a combined effect on reducing HIV transmission and infection in the community. The rate of 0.26% new HIV diagnoses found in this analysis is also lower than the rate of 0.43% new HIV diagnoses found in a hospital opt-out HIV screening program conducted in San Diego in 2009 24 , which may be attributed to the effectiveness of HIV-screening programs in San Diego.…”

Section: Discussioncontrasting

confidence: 73%

Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments

Hoenigl

Mathur

Blumenthal

et al. 2019

Sci Rep

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Universal HIV and HCV screening in emergency departments (ED) can reach populations who are less likely to get tested otherwise. The objective of this analysis was to evaluate universal opt-out HIV and HCV screening in two EDs in San Diego. HIV screening for persons aged 13–64 years (excluding persons known to be HIV+ or reporting HIV testing within last 12 months) was implemented using a 4th generation HIV antigen/antibody assay; HCV screening was offered to persons born between 1945 and 1965. Over a period of 16 months, 12,575 individuals were tested for HIV, resulting in 33 (0.26%) new HIV diagnoses, of whom 30 (90%) were successfully linked to care. Universal screening also identified 74 out-of-care for >12-months HIV+ individuals of whom 50 (68%) were successfully relinked to care. Over a one-month period, HCV antibody tests were conducted in 905 individuals with a seropositivity rate of 9.9% (90/905); 61 seropositives who were newly identified or never treated for HCV had HCV RNA testing, of which 31 (51%) resulted positive (3.4% of all participants, including 18 newly identified RNA positives representing 2% of all participants), and 13/31 individuals (42%) were linked to care. The rate of newly diagnosed HCV infections exceeded the rate of newly diagnosed HIV infections by >7-fold, underlining the importance of HCV screening in EDs.

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Section: Discussioncontrasting

confidence: 73%

Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments

Hoenigl

Mathur

Blumenthal

et al. 2019

Sci Rep

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“…Regarding rapid test implementation, different challenges have been described in the literature, including patient's acceptance of the test, the application of the test by health staff, or the adequate integration of health systems for a proper linkage to care. 32,36,37 In our study, there was a very good acceptance rate for the test and the main barrier was the lack of offering and execution of the test by the nursing staff. We found the same barriers to implementation reported in other clinical settings, which are mainly physician-led, mostly due to lack of time or work overload.…”

Section: Discussionmentioning

confidence: 58%

“…We found the same barriers to implementation reported in other clinical settings, which are mainly physician-led, mostly due to lack of time or work overload. 32,36 Strategies need to be established, such as staff education, to raise staff awareness and improve the test coverage.…”

Section: Discussionmentioning

confidence: 99%

Impact and barriers of an HIV rapid test program implementation at an oncological referral center in Mexico

et al. 2018

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The aim of this study was to evaluate the implementation of human immunodeficiency virus (HIV) screening with rapid tests in an oncologic center in Mexico City, report the HIV prevalence, and describe contacts screening and linkage to HIV care while identifying barriers to the performance of the program. In 2014, an HIV rapid test program was implemented in four departments of the hospital "Instituto Nacional de Cancerología". From 2014 to 2016, 3032 HIV rapid tests were performed in the hospital. The overall HIV prevalence was 0.8%, with the highest prevalence in the Hematology Department (2.4%). In the Gynecology Department, prevalence was 0.05%. Only 25 and 22 tests were performed in the lung cancer and germ cell tumor clinic, respectively, with one positive test. The health staff not offering the test was the main limitation to the full implementation of the program in those departments. The contacts screening led to three positive cases. The acceptance of the test was 99%. Patients who tested positive were seen by an infectious diseases physician on the same day the test was performed. Rapid HIV tests are a useful tool to expand HIV diagnosis in patients with cancer and to establish a rapid linkage to HIV care. Staff education needs to be improved to raise awareness of the health staff for a successful scale up of the program.

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“…To determine the acceptability and to describe the predictors of acceptance or refusal of HIV opt-out inpatient testing, surveys were offered to two samples: a) adult patients admitted to the hospital who had been offered an HIV test upon admission over a 3-month period and b) the medical staff of the hospital who offered the HIV tests. The survey consisted of a 5-point Likert-scale and multiple-choice questions [55]. In another study, the acceptability of a mobile health intervention to improve HIV care coordination for PLHIV with co-morbidities was evaluated by applying an interview approach.…”

Section: Resultsmentioning

confidence: 99%

A need for implementation science to optimise the use of evidence-based interventions in HIV care: A systematic literature review

et al. 2019

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To improve health outcomes in people living with HIV, adoption of evidence-based interventions (EBIs) using effective and transferable implementation strategies to optimise the delivery of healthcare is needed. ViiV Healthcare’s Positive Pathways initiative was established to support the UNAIDS 90-90-90 goals. A compendium of EBIs was developed to address gaps within the HIV care continuum, yet it was unknown whether efforts existed to adapt and implement these EBIs across diverse clinical contexts. Therefore, this review sought to report on the use of implementation science in adapting HIV continuum of care EBIs. A systematic literature review was undertaken to summarise the evaluation of implementation and effectiveness outcomes, and report on the use of implementation science in HIV care. Ten databases were reviewed to identify studies (time-period: 2013–2018; geographic scope: United States, United Kingdom, France, Germany, Italy, Spain, Canada, Australia and Europe; English only publications). Studies were included if they reported on people living with HIV or those at risk of acquiring HIV and used interventions consistent with the EBIs. A broad range of study designs and methods were searched, including hybrid designs. Overall, 118 publications covering 225 interventions consistent with the EBIs were identified. These interventions were evaluated on implementation (N = 183), effectiveness (N = 81), or both outcomes (N = 39). High variability in the methodological approaches was observed. Implementation outcomes were frequently evaluated but use of theoretical frameworks was limited (N = 13). Evaluations undertaken to assess effectiveness were inconsistent, resulting in a range of measures. This review revealed extensive reporting on implementation science as defined using evaluation outcomes. However, high variability was observed in how implementation outcomes and effectiveness were defined, quantified, and reported. A more specific and consistent approach to conducting and reporting on implementation science in HIV could facilitate achievement of UNAIDS 90-90-90 targets.

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

Cited by 16 publications

References 13 publications

Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments

Universal HIV and Birth Cohort HCV Screening in San Diego Emergency Departments

Impact and barriers of an HIV rapid test program implementation at an oncological referral center in Mexico

A need for implementation science to optimise the use of evidence-based interventions in HIV care: A systematic literature review

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