Evaluation of the Centers for Disease Control and Prevention's Recommendations Regarding Routine Testing for Human Immunodeficiency Virus by an Inpatient Service: Who Are We Missing?

Greenwald, Jeffrey L.; Rich, Catherine; Bessega, Samantha; Posner, Michael A.; Maeda, Jared Lane K.; Skolnik, Paul R.

doi:10.4065/81.4.452

Cited by 19 publications

(11 citation statements)

References 17 publications

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“…Efforts to better integrate this with HIV/STI screening and prevention would be beneficial. To further improve HIV prevention programs, it also is important to increase routine HIV testing for MSM because seropositive individuals who are aware of their serostatus often reduce their sexual risk behaviors, and also to provide appropriately tailored prevention messages for both HIV-seropostive and seronegative populations (Chou et al 2005;Fenton and Valdiserri 2006;Greenwald et al 2006;Marks et al 2005;Wolitski et al 2006). program clinics assisting our investigation, and our study participants.…”

Section: Discussionmentioning

confidence: 96%

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

et al. 2008

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We examined how drugs, high-risk sexual behaviors, and socio-demographic variables are associated with recent HIV infection among men who have sex with men (MSM) in a case-control study. Interviewers collected risk factor data among 111 cases with recent HIV infection, and 333 HIV-negative controls from Chicago and Los Angeles. Compared with controls, cases had more unprotected anal intercourse (UAI) with both HIV-positive and HIV-negative partners. MSM with lower income or prior sexually transmitted infections (STI) were more likely to be recently HIV infected. Substances associated with UAI included amyl nitrate ("poppers"), methamphetamine, Viagra (or similar PDE-5 inhibitors), ketamine, and gamma hydroxybutyrate (GHB). Cases more frequently used Viagra, poppers, and methamphetamine during UAI compared with controls. In multivariate analysis, income, UAI with HIV-positive partners, Viagra, and poppers remained associated with recent HIV seroconversion. Better methods are needed to prevent HIV among MSM who engage in high-risk sex with concurrent drug use.

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Section: Discussionmentioning

confidence: 96%

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

et al. 2008

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“…Therefore, the Centers for Disease Control (Branson et al 2006) and others (Rotheram-Borus et al 2006b) have recommended universal, opt-out routine HIV testing in general health-care settings, with posttest counseling provided only to HIV positives. Routine testing can result in three-to four-fold increases in HIV testing compared to standard physician referral (Greenwald et al 2006a) and identification of at least half of the positive cases that would have otherwise been missed (Greenwald et al 2006b). …”

Section: Biomedical Innovations Are the Wave Of The Future But The Bmentioning

confidence: 99%

The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

Rotheram‐Borus

Swendeman

Chovnick

2009

Annu. Rev. Clin. Psychol.

201

181

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In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines.

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“…[9][10][11] However, such programs have typically been implemented in large urban hospital settings, usually in emergency departments and inpatient wards. [12][13][14][15][16][17] Very few routine or rapid screening programs have been implemented in smaller healthcare settings, 10,18 and no study has, as of yet, examined the acceptability of such programs in rural areas. Limited healthcare access and HIV-associated stigma may limit the effectiveness of routine screening in rural areas.…”

Section: Introductionmentioning

confidence: 99%

A Routine HIV Screening Program in a South Carolina Community Health Center in an Area of Low HIV Prevalence

Weis

Liese

Hussey

et al. 2009

AIDS Patient Care and STDs

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In 2006, the Centers for Disease Control and Prevention published guidelines for routine HIV screening in healthcare settings. Feasibility studies have demonstrated that screening is effective in high-volume, urban settings, but there are no data for smaller, more rural settings. The main objective of this study was to describe a routine HIV screening program at a community health center in South Carolina serving both urban and rural populations. Margaret J. Weston Community Health Center implemented routine HIV screening using rapid tests at its three locations on December 1, 2006. All individuals utilizing this center over the age of 13 years were screened for HIV unless they opted out. Nurses completed a survey about their experiences with the program. chi(2) tests and logistic regression models were used to analyze the data. In the first 8 months, among 985 eligible visits, 574 (58%) resulted in the patient being screened. The most common reason for refusal was "doesn't think s/he is at risk." Acceptance rates differed significantly by location (p = 0.01), from 62% in the urban site to 47% in the rural site. Other significant predictors of accepting HIV testing were race/ethnicity, age, and method of payment. Three hundred twenty-four (58%) individuals who were tested reported no history of being previously tested for HIV infection. Participation in the screening program was perceived favorably by nurses. This pilot project in a South Carolina community health center demonstrates that implementation of routine HIV screening is acceptable in small healthcare settings and in smaller cities and rural communities in the South.

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Evaluation of the Centers for Disease Control and Prevention's Recommendations Regarding Routine Testing for Human Immunodeficiency Virus by an Inpatient Service: Who Are We Missing?

Cited by 19 publications

References 17 publications

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

A Routine HIV Screening Program in a South Carolina Community Health Center in an Area of Low HIV Prevalence

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