Assessing the National Prevalence of HIV Screening in the United States using Electronic Health Record Data

Joshua D Niforatos; Jonathon W Wanta; Emily Durbak; Jacqueline Cavendish; Justin A Yax

doi:10.7759/cureus.5043

Assessing the National Prevalence of HIV Screening in the United States using Electronic Health Record Data

Cureus. 2019 Jun 30;11(6):e5043. doi: 10.7759/cureus.5043.

Authors

Joshua D Niforatos¹, Jonathon W Wanta², Emily Durbak³, Jacqueline Cavendish⁴, Justin A Yax⁵

Affiliations

¹ Emergency Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, USA.
² Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA.
³ Miscellaneous, Case Western Reserve University, Cleveland Clinic Lerner College of Medicine, Cleveland, USA.
⁴ Emergency Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.
⁵ Emergency Medicine and Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA.

Abstract

The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend population-based screening for human immunodeficiency virus (HIV) at least once in each patient's life. National surveys estimate that 42.5% of the population has been screened; however, these studies have relatively low sample sizes and inherent survey biases. Using a national, de-identified cloud-based electronic health record (EHR) information from over 48 million patients, we found that only 6.4% of Americans over the age of 18 had laboratory evidence of a prior HIV test. Further investigation is necessary to determine if single-item questions on national surveys correlate with objective evidence of HIV testing, as well as addressing the numerous limitations related to the use of EHR data that likely grossly underestimates the prevalence of HIV screening nationally.

Keywords: electronic health record; health care technology; hiv screening.