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Karen A. Kroc, BS1, Sabrina R. Kendrick, MD1,2,3, Eileen
Couture, MD2, Shayle Miller, MD2, David Withum, Dr PH4,
Robert J. Rydman, PhD2, Bernard Branson, MD4, Robert A.
Weinstein, MD1,2,3
1The CORE Center, Cook County Bureau of Health Services, 2020
W. Harrison Street, Chicago, IL 60612, 2Cook County Hospital, Chicago,
IL, 3Rush Medical College, Chicago, IL, 4CDC, Atlanta,
GA
Background: The Cook County Hospital ED began offering conventional
HIV counseling and testing (CT) in January 2001. Though June 2001, 77 patients
(pts) received CT. Previously the ED referred pts to ambulatory clinics for
CT. Rapid HIV testing (RT) was introduced in the ED in June 2001.
Methods: SUDS testing was offered 6/19/01 - 2/28/02 to pts age 18 –
60. All specimens received a subsequent EIA. Known HIV pts were excluded. Health
educators were responsible for HIV counseling, phlebotomy, and RT. Upon receipt
of RT results all positive pts were scheduled for evaluation at our retroviral
clinic (CORE).
Results: 7072 pts were approached. Of 6038 (85%) eligibles, 1652 (27%)
were RT and 1651 (99.3%) received results before discharge. HIV infections were
identified in 46 (2.8%)-- 8 females and 38 males, with a median age of 39. Thirty-two
(70%) reported being heterosexual; 27 (59%) reported no known risk factors.
Previous HIV testing was reported by 26/46 (57%). 36/46 (78%) reported for evaluation
at CORE, 22 (48%) as scheduled, 14 (30%) as rescheduled and one pt expired prior
to appointment. Median time from RT to CORE visit was 13 days (range 4-114 days).
HIV status: CD4 (cells/mm3): median 116, with 28 <350; viral load
(copies/ml): median 65,574, range <50-750,000.
Conclusions: ED pts may be unaware of their HIV serostatus and often
accept testing if offered. Point of care RT in the ED is feasible and provides
pts timely results. Entry into HIV care may be facilitated when testing, results,
and referral to care are all provided during one visit.
Accepted for presentation at American Public Health Association Annual Meeting,
2002
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