OBJECTIVE: Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our ED's HIV prevention counseling and testing program. METHODS: Our urban, academic ED provides formal client-centered prevention counseling in conjunction with HIV testing. Five descriptive, exploratory observations were conducted, involving surveys and analysis of electronic medical records and programmatic data focused on (1) patient perception and feasibility of prevention counseling in the ED, (2) patient perceptions of the need to link prevention counseling with testing, and (3) potential effectiveness of providing prevention counseling in conjunction with ED-based HIV testing. RESULTS: Of 110 ED patients surveyed after prevention counseling and testing, 98% believed privacy was adequate, and 97% reported that their questions were answered. Patients stated that counseling would lead to improved health (80%), behavioral changes (72%), follow-up testing (77%), and discussion with partners (74%). However, 89% would accept testing without counseling, 32% were willing to seek counseling elsewhere, and 26% preferred not to receive the counseling. Correct responses to a 16-question knowledge quiz increased by 1.6 after counseling (95% confidence interval 1.3 to 12.0). The program completed counseling for 97% of patients tested; however, 6% of patients had difficulty recalling the encounter and 13% denied received testing. Among patients undergoing repeated testing, there was no consistent change in self-reported risk behaviors. CONCLUSION: Participants in the ED prevention counseling and testing program considered counseling acceptable and useful, though not required. Given adequate resources, prevention counseling can be provided in the ED, but it is unlikely that all patients benefit.
OBJECTIVE: Controversy surrounds the linkage of prevention counseling with emergency department (ED)-based HIV testing. Further, the effectiveness and feasibility of prevention counseling in the ED setting is unknown. We investigate these issues by conducting a preliminarily exploration of several related aspects of our ED's HIV prevention counseling and testing program. METHODS: Our urban, academic ED provides formal client-centered prevention counseling in conjunction with HIV testing. Five descriptive, exploratory observations were conducted, involving surveys and analysis of electronic medical records and programmatic data focused on (1) patient perception and feasibility of prevention counseling in the ED, (2) patient perceptions of the need to link prevention counseling with testing, and (3) potential effectiveness of providing prevention counseling in conjunction with ED-based HIV testing. RESULTS: Of 110 ED patients surveyed after prevention counseling and testing, 98% believed privacy was adequate, and 97% reported that their questions were answered. Patients stated that counseling would lead to improved health (80%), behavioral changes (72%), follow-up testing (77%), and discussion with partners (74%). However, 89% would accept testing without counseling, 32% were willing to seek counseling elsewhere, and 26% preferred not to receive the counseling. Correct responses to a 16-question knowledge quiz increased by 1.6 after counseling (95% confidence interval 1.3 to 12.0). The program completed counseling for 97% of patients tested; however, 6% of patients had difficulty recalling the encounter and 13% denied received testing. Among patients undergoing repeated testing, there was no consistent change in self-reported risk behaviors. CONCLUSION:Participants in the ED prevention counseling and testing program considered counseling acceptable and useful, though not required. Given adequate resources, prevention counseling can be provided in the ED, but it is unlikely that all patients benefit.
Authors: Freya Spielberg; Bernard M Branson; Gary M Goldbaum; David Lockhart; Ann Kurth; Connie L Celum; Anthony Rossini; Cathy W Critchlow; Robert W Wood Journal: J Acquir Immune Defic Syndr Date: 2003-03-01 Impact factor: 3.731
Authors: Michael S Lyons; Christopher J Lindsell; Jason S Haukoos; Gregory Almond; Jeremy Brown; Yvette Calderon; Eileen Couture; Roland C Merchant; Douglas A E White; Richard E Rothman; Chris Aldridge; Gregory Almond; Gregory Andrade; Christian Arbelaez; Tom-meka Archinard; Steven I Aronin; Susan Barrera; Moses Bateganya; Joanna Bell-Merriam; Bob Bongiovanni; Kathleen Brady; Bernard Branson; Carol Brosgart; Jeremy Brown; Evan Cadoff; Yvette Calderon; Linda Chaille-Arnold; Ben Cheng; William Chiang; Brittney Copeland; Rosalyn L Cousar; Eileen Couture; Maggie Czarnogorski; Kit Delgado; Emily Erbelding; James Feldman; Osvaldo Garcia; Charlotte A Gaydos; Nancy Glick; Barbara Gripshover; Jason Haukoos; Alisa Hayes; James Heffelfinger; Laura Herrera; Amy Hilley; David Holtgrave; Brooke Hoots; Emily Hopkins; Debra Houry; Debra Howell; Yu-Hsiang Hsieh; Angela B Hutchinson; Blanca Jackson; Michael Jaker; Kerin Jones; Juliana Jung; Linda Kampe; Virginia Kan; Nancy Kass; Gabor D Kelen; Karen Kroc; Ann Kurth; Margaret A Lampe; Jason Leider; Michael Lemanski; Christopher J Lindsell; Michael Lyons; Sandra McGovern; Seth Mercer; Roland Merchant; Nancy Miertschin; Joan Miller; Patricia Mitchell; Sarah Nelson; Linda Onaga; David Paltiel; Sindy Paul; Harold Pollack; Stephen Raffanti; Liisa Randall; Richard Rothman; Akhter Sabreen; Jeffrey Sankoff; Vanessa Sasso; Nathaniel Bernard Saylor; Elissa Schechter; Barbara Schechtman; Steven Schrantz; Alicia Scribner; Judy Shahan; Daniel Skiest; Freya Spielberg; Irijah S Stennett; Patrick Sullivan; Cathalene Teahan; Susan Thompson; Gretchen Torres; Vicken Totten; Krystn Wagner; Rochelle Walensky; Michael Waxman; Andrea Weddle; Douglas White; Tom Widell; James A Wilde; Keith Wrenn; Juliet Yonek Journal: Acad Emerg Med Date: 2008-12-06 Impact factor: 3.451
Authors: Kiran A Faryar; Heather Henderson; Jason W Wilson; Bhakti Hansoti; Larissa S May; Elissa M Schechter-Perkins; Michael J Waxman; Richard E Rothman; Jason S Haukoos; Michael S Lyons Journal: J Am Coll Emerg Physicians Open Date: 2021-06-22