Experiences Implementing a Routine HIV Screening Program in Two Federally           Qualified Health Centers in the Southern United States

Crumby, Natasha S.; Arrezola, Erica; Brown, Emily; Brazzeal, Angela F; Sanchez, Travis

doi:10.1177/00333549161310s104

Cited by 16 publications

(16 citation statements)

References 10 publications

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“…look-alike health centers (community-based health centers that meet the requirements of the HRSA Health Center Program, but do not receive Health Center Program funding § § ) since 2014. ¶ ¶ Some CHCs have also implemented clinical decision support algorithms for increasing HIV testing (5,6). HIV testing did not increase in physician offices during 2014-2016, despite elimination of patient cost-sharing, possibly because testing barriers unrelated to cost have not been addressed (e.g., dependence on busy providers to order HIV tests).…”

Section: Discussionmentioning

confidence: 99%

HIV Testing Trends at Visits to Physician Offices, Community Health Centers, and Emergency Departments — United States, 2009–2017

Hoover¹,

Huang²,

Tanner³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 99%

HIV Testing Trends at Visits to Physician Offices, Community Health Centers, and Emergency Departments — United States, 2009–2017

Hoover¹,

Huang²,

Tanner³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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“…Most impressively, our linkage to care rates of 64% (HCV) and 100% (HIV) are among some of the highest reported, which has typically been shown to vary between 30-40% for HCV and 60-80% for HIV seropositive patients, respectively. [16,17,19] Our rates may be higher than prior studies for a number of reasons. First, PNs were able to contact patients via texting per patient preference, and texting as a means of contacting patients-particularly younger patients-has been suggested as a successful strategy for hard-to-reach patients such as PWID and is novel to our FOCUS study.…”

Section: Resultsmentioning

confidence: 56%

“…[13] Previous studies have successfully used the EMR to increase screening for HIV and other infectious diseases. [14][15][16][17][18][19] However, all were conducted in urban areas not currently in the midst of a burgeoning opioid epidemic like the current one affecting central Appalachia.…”

Section: Importancementioning

confidence: 99%

Using the Electronic Medical Record to Increase Testing for HIV and Hepatitis C Virus in An Appalachian Emergency Department

Burrell

Sharon

Davis

et al. 2020

Preprint

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Background: The ongoing Appalachian opioid epidemic has led to increasing hepatitis C virus (HCV) infections among people who inject drugs (PWID), and Human Immunodeficiency Virus (HIV) outbreaks have been observed. The primary objective of this study was to use the electronic medical record (EMR) to increase HIV and HCV testing in a central Appalachian academic emergency department. A secondary objective was to increase linkage to care using patient navigators. Methods: EMR algorithms based on current Centers for Disease Control and Prevention HIV and HCV testing recommendations were created that triggered Best Practice Alerts (BPAs), giving providers a one-click acceptance option to order HIV and/or HCV testing. Placards were placed in care areas, informing patients of the availability of routine screening. Patient navigators facilitated linkage to care for seropositive patients. Results: The BPA appeared 58,936 times on 21,098 patients eligible for HIV screening and 24,319 times on 11,989 patients eligible for HCV screening over a one-year period. Of those, 7,106 (33.7%) patients were screened for HIV and 3,496 (29.2%) patients were screened for HCV, for an overall testing increase of 2,269% and 1,065% for HIV and HCV, respectively. Linkage to care increased by 15% for HIV to 100%, and 14% for HCV to 64%. Conclusion: HIV and HCV screening and linkage to care were increased in an academic ED setting in central Appalachia using EMR alerts. This approach could be utilized in multiple ambulatory settings. Increased testing and earlier linkage to care may help combat the current injection drug use-related HCV epidemic and avoid additional HIV outbreaks

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“…The objectives of routine screening are to increase the proportion of HIV-infected individuals who are aware of their infection, facilitate early HIV diagnosis, provide timely linkage to care, and normalize screening to reduce stigma associated with HIV testing. Several studies have shown that offering routine screening is, indeed, associated with an increased uptake of testing, especially when testing is recommended by a healthcare provider [2–8].…”

Section: Introductionmentioning

confidence: 99%

“…Among these individuals, 75% reported not being offered an HIV test during any of their healthcare visits [14]. Such findings may be attributed to a lack of provider awareness about HIV testing guidelines and failure to implement operational procedures for routine testing [2, 15–16]. A 2014 review of HIV testing barriers found that only 2.0–35.8% of providers offer routine HIV testing while most continue to perform risk-based testing [15].…”

Section: Introductionmentioning

confidence: 99%

Missed Opportunities for HIV Testing Among STD Clinic Patients

2018

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Current HIV testing guidelines recommend that all adolescents and adults aged 13-64 be routinely screened for HIV in healthcare settings. Sexually transmitted disease (STD) clinic patients represent a population at increased risk for HIV, justifying more frequent risk assessment and testing. This analysis describes missed opportunities for HIV testing among a sample of STD clinic patients to identify areas where HIV testing services may be improved. Secondary analysis was conducted using data from Project AWARE, a randomized trial of 5012 adult patients from 9 STD clinics in the United States, enrolled April-December 2010. HIV testing history, healthcare service utilization, and behavioral risks were obtained through audio computer-assisted self-interview. Missed opportunities for HIV testing, defined as having a healthcare visit but no HIV test in the last 12 months, were characterized by location and frequency. Of 2315 (46.2%) participants not tested for HIV in the last 12 months, 1715 (74.1%) had a missed opportunity for HIV testing. These missed opportunities occurred in both traditional (54.9% at family doctor, 20.3% at other medical doctor visits) and non-traditional (28.5% at dental, 19.0% at eye doctor, 13.9% at correctional facility, and 13.3% at psychology visits) testing settings. Of 53 participants positive for HIV at baseline, 16 (30.2%) had a missed testing opportunity. Missed opportunities for HIV testing were common in this population of STD clinic patients. There is a need to increase routinized HIV screening and expand testing services to a broader range of healthcare settings.

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Experiences Implementing a Routine HIV Screening Program in Two Federally Qualified Health Centers in the Southern United States

Abstract: Southside and Central Care effectively implemented routine HIV screening programs that dramatically increased their testing volume while also linking the majority of HIV-positive patients to care. Other community health centers should consider similar programs.

Cited by 16 publications

References 10 publications

HIV Testing Trends at Visits to Physician Offices, Community Health Centers, and Emergency Departments — United States, 2009–2017

HIV Testing Trends at Visits to Physician Offices, Community Health Centers, and Emergency Departments — United States, 2009–2017

Using the Electronic Medical Record to Increase Testing for HIV and Hepatitis C Virus in An Appalachian Emergency Department

Missed Opportunities for HIV Testing Among STD Clinic Patients

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