A model for routine hospital-wide HIV screening: lessons learned and public health implications

J Natl Med Assoc. 2010 Dec;102(12):1165-72. doi: 10.1016/s0027-9684(15)30771-9.

Abstract

Background: Approximately 232700 (21%) of Americans are unaware of their HIV-seropositive status; this represents a potential for virus transmission. Revised recommendations from the Centers for Disease Control for HIV screening promote routine screening in the health care setting. We describe the implementation of a hospital-wide routine HIV screening program in the District of Columbia.

Methods: Rapid HIV testing was conducted at Howard University Hospital on consenting patients at least 18 years of age using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. The study population includes Howard University Hospital patients who were offered HIV screening over a 12-month period at no cost. Screened patients received immediate test results and, for those patients found to be preliminarily reactive, confirmatory testing and linkage to care were offered.

Results: Of the 12836 patients who were offered testing, 7528 (58.6%) consented. Preliminary reactive test results were identified in 176 patients (2.3%). Overall, 45.5% were confirmed, of which 82.5% were confirmed positive. Screening protocol changes have led to 100% confirmation since implementation.

Conclusions: Hospital-wide routine HIV screening is feasible and can be implemented effectively and efficiently. The HIV screening campaign instituted at Howard University Hospital identified a substantial number of HIV-positive individuals and provided critical connection to follow-up testing, counseling, and disease management services.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chi-Square Distribution
  • District of Columbia / epidemiology
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • Hospitals*
  • Humans
  • Male
  • Mass Screening / organization & administration*
  • Middle Aged
  • Models, Organizational*
  • Public Health Practice*