Uriel R Felsen1, Aileen Tlamsa2, Lorlette Moir3, Shuchin Shukla4,5, Devin Thompson1, Jeffrey M Weiss1, Moonseong Heo6, Alain H Litwin7,8,9. 1. Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA. 2. Department of Medicine, Englewood Hospital and Medical Center, Englewood, NJ, USA. 3. Division of Public Health Services, New Hampshire Department of Health and Human Services, Concord, NH, USA. 4. Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA. 5. Department of Family Medicine, Mountain Area Health Education Center, Asheville, NC, USA. 6. Department of Public Health Sciences, Clemson University, Clemson, SC, USA. 7. Department of Medicine, University of South Carolina School of Medicine, Greenville, SC, USA. 8. Clemson University School of Health Research, Clemson, SC, USA. 9. Prisma Health, Greenville, SC, USA.
Abstract
OBJECTIVES: Routine screening for HIV and hepatitis C virus (HCV) among specified age cohorts is recommended. New York State requires consent before screening for HIV but not HCV. We sought to estimate the effect of the consent requirement on screening rates for HIV. METHODS: We performed a retrospective study of patients hospitalized in 2015-2016 at a tertiary care hospital in the Bronx, New York, during a period when prompts in the electronic health record facilitated screening for HIV and HCV among specified age cohorts. We compared proportions of patients eligible for screening for HIV and/or HCV who underwent screening and used generalized estimating equations and a meta-analytic weighted average to estimate an adjusted risk difference between undergoing HIV screening and undergoing HCV screening. RESULTS: Among 11 938 hospitalized patients eligible for HIV and/or HCV screening, 38.5% underwent screening for HIV and 59.1% underwent screening for HCV. The difference in screening rates persisted after adjusting for patient and admission characteristics (adjusted risk difference = 22.0%; 95% CI, 20.6%-23.4%). CONCLUSIONS: Whereas the requirement for consent was the only difference in the processes of screening for HIV compared with screening for HCV, differences in how the 2 viruses are perceived may also have contributed to the difference in screening rates. Nevertheless, our findings suggest that requiring consent continues to impede progress toward the public health goal of routine HIV screening.
OBJECTIVES: Routine screening for HIV and hepatitis C virus (HCV) among specified age cohorts is recommended. New York State requires consent before screening for HIV but not HCV. We sought to estimate the effect of the consent requirement on screening rates for HIV. METHODS: We performed a retrospective study of patients hospitalized in 2015-2016 at a tertiary care hospital in the Bronx, New York, during a period when prompts in the electronic health record facilitated screening for HIV and HCV among specified age cohorts. We compared proportions of patients eligible for screening for HIV and/or HCV who underwent screening and used generalized estimating equations and a meta-analytic weighted average to estimate an adjusted risk difference between undergoing HIV screening and undergoing HCV screening. RESULTS: Among 11 938 hospitalized patients eligible for HIV and/or HCV screening, 38.5% underwent screening for HIV and 59.1% underwent screening for HCV. The difference in screening rates persisted after adjusting for patient and admission characteristics (adjusted risk difference = 22.0%; 95% CI, 20.6%-23.4%). CONCLUSIONS: Whereas the requirement for consent was the only difference in the processes of screening for HIV compared with screening for HCV, differences in how the 2 viruses are perceived may also have contributed to the difference in screening rates. Nevertheless, our findings suggest that requiring consent continues to impede progress toward the public health goal of routine HIV screening.
Entities:
Keywords:
HCV screening; HIV screening; consent; routine screening
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