S. Kendrick, MD^1,2,3, K. Kroc, BS¹, D. Withum, DrPH⁴, R. Rydman, PhD², B. Branson, MD⁴, J. McAuley, MD⁵, C. Mennella, MD⁵, E. Couture, DO², S. Miller, MD², R. Weinstein, MD^1,2,3.
¹CORE Center, Chicago, IL; ²Cook County Hospital, Chicago, IL; ³Rush Medical College, Chicago, IL, ⁴CDC, Atlanta, GA; ⁵Cook County Jail, Chicago, IL

Background: Delayed or non-receipt of HIV test results and delayed entry into care for HIV positive (HIV+) individuals are common problems for public clinics. The purpose of this study was to assess the feasibility and acceptability of rapid HIV testing (RT) at three high-volume, high-prevalence public venues.

Methods: RT with SUDS® HIV-1 test was offered at 3 sites: an STD clinic, female receiving at a county jail, and a public hospital emergency department (ED). Patients (pts)  ≥18 years of age, able to provide informed consent, and not known to be HIV+ were eligible. EIA was also performed on all specimens, and a Western blot on repeatedly reactive specimens. Health educators performed all counseling, phlebotomy, and RT.

Results: Acceptance of RT and the number of HIV+ pts discovered and who entered into primary care differed at the 3 sites (table). More than 98% of all pts received HIV test results before leaving.

Two HIV+ pts expired (1 STD, 1 ED) prior to first primary care visit. Documented entry into care for HIV+ pts was 100% for the STD clinic (n= 36, median 10 days), 22% for the Jail (n= 2, median 49.5 days), and 80% for the ED (n= 36, median 14 days).

Conclusions: Acceptance of RT was lowest in the ED but the number of new HIV+ patients diagnosed was greater than in the STD clinic where acceptance was highest.  Prompt entry into care after RT was high for both settings. New HIV+ pts discovered by RT in the jail receiving area will require additional efforts to insure entry into care.

Presented at 40^th Annual Meeting of Infectious Disease Society of America, Chicago, October 24-27, 2002