S. Kendrick, MD1,2,3, 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,
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
Methods: RT with SUDSŪ 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,
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.
|# months RT offered
|# (%) eligible
|# (%) accepted RT
|# (%) new HIV+
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 40th Annual Meeting of Infectious Disease Society
of America, Chicago, October 24-27, 2002