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K. Kroc1, S. Kendrick1,2,3, D. Withum4,
E. Couture2, S. Miller2, B. Zagorski2, B. Branson4,
R. Weinstein1,2,3.
1CORE Center, Chicago, IL;
2Cook County Hospital, Chicago, IL; 3Rush Medical College,
Chicago, IL; 4CDC, Atlanta, GA
Background: Many patients use the Emergency Department (ED) for primary
care, including STD treatment. Historically, the Cook County Hospital ED has
referred patients seeking conventional HIV testing (CT) to ambulatory care clinics
or to the CORE Center STD Screening Clinic (CORE). The ED began CT in January
2001 and through May, 56 patients had received CT in the ED and 18% (10/56)
reported to the CORE STD clinic or other hospital sites to receive their test
results.
Objectives: To determine if point-of-care rapid HIV testing
(RT) is feasible in a large urban hospital ED.
Methods: SUDSŪ HIV-1 test was offered to ED patients ages 18-60 beginning
in June 2001. Known HIV+ patients were excluded. Health educators actively
encouraged RT, obtained informed consent, and performed all counseling, phlebotomy,
and RT.
Results: For the RT period June through August 2001, 82% (1717/2099)
of patients were eligible, 24% (410/1717) accepted RT. Twelve (2.9%) new HIV
infections were identified. 98% (405/410) of patients received results and post-test
counseling within 90 minutes of pretest counseling.
Conclusions: Point-of-care RT is feasible and accepted by a subset of
ED patients. RT improves client receipt of HIV test results.
Implications for Programs/Policy: STD prevention programs should consider
establishing linkages with EDs to foster HIV testing. EDs should consider using
RT to reduce the need for additional follow up and increase client receipt of
results.
Implications for Research: Reasons for the relatively low test acceptance
rate in ED require further study. Studies to evaluate use of candidate simple,
quick HIV rapid tests capable of reducing test turn around time in ED settings
are warranted.
Presented at the 2002 National STD Prevention Conference, March 4-7, 2002,
San Diego, CA.
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