Pamela W Klein1, Ian B K Martin2, Evelyn B Quinlivan3, Cynthia L Gay2, Peter A Leone2. 1. The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC ; Medical College of Wisconsin, Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Milwaukee, WI. 2. The University of North Carolina at Chapel Hill, School of Medicine, Departments of Emergency Medicine and Internal Medicine, Chapel Hill, NC. 3. The University of North Carolina at Chapel Hill, School of Medicine, Center for Infectious Diseases, Chapel Hill, NC.
Abstract
OBJECTIVES: We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. METHODS: We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18-64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. RESULTS: Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25-34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). CONCLUSIONS: Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.
OBJECTIVES: We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. METHODS: We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18-64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. RESULTS: Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25-34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). CONCLUSIONS: Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.
Authors: Ronald J Lubelchek; Karen A Kroc; David L Levine; Kathleen G Beavis; Rebeca R Roberts Journal: Ann Emerg Med Date: 2011-07 Impact factor: 5.721
Authors: D W Cameron; J N Simonsen; L J D'Costa; A R Ronald; G M Maitha; M N Gakinya; M Cheang; J O Ndinya-Achola; P Piot; R C Brunham Journal: Lancet Date: 1989-08-19 Impact factor: 79.321
Authors: Jennifer C Chen; Matthew Bidwell Goetz; Jamie E Feld; Anne Taylor; Henry Anaya; Jane Burgess; Richard de Mesa Flores; Risha A Gidwani; Herschel Knapp; Elizabeth H Ocampo; Steven M Asch Journal: Am J Emerg Med Date: 2010-04-02 Impact factor: 2.469
Authors: Yvette Calderon; Jason Leider; Susan Hailpern; Robert Chin; Reena Ghosh; Jade Fettig; Paul Gennis; Polly Bijur; Laurie Bauman Journal: AIDS Patient Care STDS Date: 2009-09 Impact factor: 5.078
Authors: Jason Zucker; Lawrence Purpura; Fereshteh Sani; Simian Huang; Aaron Schluger; Kenneth Ruperto; Jacek Slowkowski; Susan Olender; Matt Scherer; Delivette Castor; Peter Gordon Journal: AIDS Patient Care STDS Date: 2022-03 Impact factor: 5.944
Authors: Jason Zucker; Caroline Carnevale; Deborah A Theodore; Delivette Castor; Kathrine Meyers; Jeremy A W Gold; Daniel Winetsky; Matt Scherer; Alwyn Cohall; Peter Gordon; Magdalena E Sobieszczyk; Susan Olender Journal: Sex Transm Dis Date: 2021-10-01 Impact factor: 3.868
Authors: Ashley A Lipps; Jose A Bazan; Mark E Lustberg; Mohammad Mahdee Sobhanie; Brandon Pollak; Kushal Nandam; Susan L Koletar; Sommer Lindsey; Michael Dick; Carlos Malvestutto Journal: Sex Transm Dis Date: 2022-01-01 Impact factor: 2.830