Use of tablet-based kiosks in the emergency department to guide patient HIV self-testing with a point-of-care oral fluid test

Gaydos, Charlotte A.; Solis, Melissa; Hsieh, Yu Hsiang; Jett-Goheen, Mary; Nour, Samah; Rothman, Richard E.

doi:10.1177/0956462413487321

Cited by 42 publications

(69 citation statements)

References 9 publications

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“…In an urban sexually transmitted disease clinic, 80% of eligible patients accepted HIV testing and 87% of those accepted POC HIV tests [131]. Patients will even accept to perform their own HIV test in Emergency Departments with some being recruited via kiosks [107,108,110]. …”

Section: New Hiv Poc Testsmentioning

confidence: 99%

Point of care diagnostics for sexually transmitted infections: perspectives and advances

Gaydos

Hardick

2014

Expert Review of Anti-infective Therapy

120

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Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexually transmitted infection (STI) epidemics, so that patients can receive immediate diagnoses and treatment. Current POC assays for Chlamydia trachomatis and Neisseria gonorrhoeae perform inadequately and require better assays. Diagnostics for Trichomonas vaginalis rely on wet preparation, with some notable advances. Serological POC assays for syphilis can impact resource-poor settings, with many assays available, but only one available in the U.S. HIV POC diagnostics demonstrate the best performance, with excellent assays available. There is a rapid assay for HSV lesion detection; but no POC serological assays are available. Despite the inadequacy of POC assays for treatable bacterial infections, application of technological advances offers the promise of advancing POC diagnostics for all STIs.

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Section: New Hiv Poc Testsmentioning

confidence: 99%

Point of care diagnostics for sexually transmitted infections: perspectives and advances

Gaydos

Hardick

2014

Expert Review of Anti-infective Therapy

120

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“…A study of adult emergency room patients in Baltimore, MD, USA showed that: 96.1% agreed to a self-point-of-care HIV test; 100% had concordant results with those of a trained provider; 91.7% “trusted the results very much”; and 98.4% reported performing the test was “easy” 33. An emergency department study that offered oral fluid self-tests and directions on tablet-based kiosks found that 49.5% accepted testing, and 100% of results were concordant between users and trained providers 34. Another study in Baltimore offered oral or finger stick self-testing to emergency room patients undergoing point-of-care oral fluid testing by a health care professional and showed that: 85% of participants consented to self-testing; 91% chose oral fluid over finger stick; 99.6% of self-test results agreed with health care professionals’ results; and 84.4% of testers trusted their result 35.…”

Section: Arguments For Hiv Self-testing: Accessibility; Accuracy; Empmentioning

confidence: 99%

Arguments for and against HIV self-testing

Wood¹,

Ballenger²,

Stekler³

2014

HIV

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Approximately 60% of human immunodeficiency virus (HIV)-infected individuals are unaware of their infection, and stigma and discrimination continue to threaten acceptance of HIV testing services worldwide. Self-testing for HIV has garnered controversy for years and the debate reignited with the approval of a point-of-care test for over-the-counter sale in the US in 2012. Here, we present arguments for and against HIV self-testing. The case in support of HIV self-testing contends that: the modality is highly acceptable, especially among the most at-risk individuals; self-testing empowers users, thus helping to normalize testing; and mutual partner testing has the potential to increase awareness of risk and avert condomless sex between discordant partners. Arguments against HIV self-testing include: cost limits access to those who need testing most; false-negative results, especially during the window period, may lead to false reassurance and could promote sex between discordant partners at the time of highest infectivity; opportunities for counseling, linkage to care, and diagnosis of other sexually transmitted infections may be missed; and self-testing leads to potential for coercion between partners. Research is needed to better define the risks of self-testing, especially as performance of the assays improves, and to delineate the benefits of programs designed to improve access to self-test kits, because this testing modality has numerous potential advantages and drawbacks.

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“…15 Haukoos et al . evaluated the use of triage-based kiosks to obtain consent for HIV screening in an ED.…”

Section: Introductionmentioning

confidence: 99%

An emergency department registration kiosk can increase HIV screening in high risk patients

et al. 2014

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Summary We evaluated the feasibility and the patient acceptability of integrating a kiosk into routine emergency department (ED) practice for offering HIV testing. The work was conducted in four phases: phase 1 was a baseline, in which external testing staff offered testing at the bedside; phase 2 was a pilot assessment of a prototype kiosk; phase 3 was a pilot implementation and phase 4 was the full implementation with automated login. Feasibility was assessed by the proportion of offering HIV tests, acceptance, completion and result reporting. During the study period, the number of ED patients and eligible patients for screening were similar in the three main phases. However, the number and proportion of patients offered testing of those eligible for screening increased significantly from phase 1 (32%) to phase 3 (37%) and phase 4 (40%). There were slightly higher prevalences of newly diagnosed HIV with kiosk versus bedside testing (phase 1, 0%; phase 3, 0.2%; phase 4, 0.5%). Compared to patients tested at the bedside, patients tested via the kiosk were significantly younger, more likely to be female, to be black, and to report high risk behaviours. ED-based HIV screening via a registration-based kiosk was feasible, yielded similar proportions of testing, and increased the proportion of engagement of higher-risk patients in testing.

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Use of tablet-based kiosks in the emergency department to guide patient HIV self-testing with a point-of-care oral fluid test

Cited by 42 publications

References 9 publications

Point of care diagnostics for sexually transmitted infections: perspectives and advances

Point of care diagnostics for sexually transmitted infections: perspectives and advances

Arguments for and against HIV self-testing

An emergency department registration kiosk can increase HIV screening in high risk patients

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