Correlates of HIV Testing Refusal Among Emergency Department Patients in the Opt-Out Testing Era
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Opt-out HIV screening is recommended by the CDC for patients in all healthcare settings. We examined correlates of HIV testing refusal among urban emergency department (ED) patients. Confidential free HIV screening was offered to 32,633 ED patients in an urban tertiary care facility in Washington, DC, during May 2007–December 2011. Demographic differences in testing refusals were examined using χ2 tests and generalized linear models. HIV testing refusal rates were 47.7 % 95 % CI (46.7–48.7), 11.7 % (11.0–12.4), 10.7 % (10.0–11.4), 16.9 % (15.9–17.9) and 26.9 % (25.6–28.2) in 2007, 2008, 2009, 2010 and 2011 respectively. Persons 33–54 years of age [adjusted prevalence ratio (APR) 1.42, (1.36–1.48)] and those ≥55 years [APR 1.39 (1.31–1.47)], versus 33–54 years; and females versus males [APR 1.07 (1.02–1.11)] were more likely to refuse testing. Opt-out HIV testing is feasible and sustainable in urban ED settings. Efforts are needed to encourage testing among older patients and women.
- Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data: United States and 6 U.S. dependent areas—2010. HIV Surveillance Supplemental Report. 2012; 17(No. 3, part A). http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Accessed 1 Jun 2013.
- Rapid HIV testing in emergency departments—three U.S. sites, January 2005–March 2006. MMWR Morb Mortal Wkly Rep. 2007; 56(24): 597–601.
- Marks G, et al. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4):446–53. CrossRef
- Branson BM, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(RR-14):1–17.
- Moyer VA. Screening for HIV: U.S. preventive services task force recommendation statement. Ann Intern Med. 2013;159(1):51–60.
- Recommendations for HIV testing services for inpatients and outpatients in acute-care hospital settings. MMWR Morb Mortal Wkly Rep. 1993; 42(8):157–158.
- Revised guidelines for HIV counseling, testing, and referral. MMWR Recomm Rep. 2001; 50(RR-19):1-57; quiz CE1-19a1-CE6-19a1.
- Screening for HIV: recommendation statement. Ann Intern Med. 2005; 143(1):32–37.
- Torres M. Rapid HIV screening in the emergency department. Emerg Med Clin North Am. 2010;28(2):369–80 (Table of Contents). CrossRef
- Rothman RE, et al. US emergency department HIV testing practices. Ann Emerg Med. 2009;58(1):S3–9. CrossRef
- Brown J, et al. Routine HIV screening in the emergency department using the new US Centers for Disease Control and Prevention Guidelines: results from a high-prevalence area. J Acquir Immune Defic Syndr. 2007;46(4):395–401. CrossRef
- Pisculli ML, et al. Factors associated with refusal of rapid HIV testing in an emergency department. AIDS Behav. 2011;15(4):734–42. CrossRef
- Liddicoat RV, et al. Refusing HIV testing in an urgent care setting: results from the “Think HIV” program. AIDS Patient Care STDS. 2006;20(2):84–92. CrossRef
- Silva A, et al. Implementing an HIV and sexually transmitted disease screening program in an emergency department. Ann Emerg Med. 2007;49(5):564–72. CrossRef
- Merchant RC, et al. Emergency department patient acceptance of opt-in, universal, rapid HIV screening. Public Health Rep. 2008;123(Suppl 3):27–40.
- Heijman RL, et al. Opting out increases HIV testing in a large sexually transmitted infections outpatient clinic. Sex Transm Infect. 2009;85(4):249–55. CrossRef
- Batey DS, et al. Short communication routine HIV testing in the emergency department: assessment of patient perceptions. AIDS Res Hum Retrovir. 2012;28(4):352–6. CrossRef
- Brown J, et al. Patient perceptions and acceptance of routine emergency department HIV testing. Public Health Rep. 2008;123(3):21–6.
- Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2011. HIV Surveillance Report. 2011; 23. http://www.cdc.gov/hiv/topics/surveillance/resources/reports/. Accessed 1 Jun 2013.
- Centers for Disease Control and Prevention. Diagnoses of HIV infection among adults aged 50 years and older in the United States and dependent areas, 2007–2010. HIV Surveillance Supplemental Report. 2013; 18(3).
- Camoni L, et al. Late presenters among persons with a new HIV diagnosis in Italy, 2010–2011. BMC Public Health. 2013;13:281. CrossRef
- Smith RD, et al. HIV transmission and high rates of late diagnoses among adults aged 50 years and over. AIDS. 2010;24(13):2109–15. CrossRef
- Ford CL et al (2013) Belief in AIDS-related conspiracy theories and mistrust in the government: relationship with HIV testing among at-risk older adults. Gerontologist.
- Zingmond DS, et al. Circumstances at HIV diagnosis and progression of disease in older HIV-infected Americans. Am J Public Health. 2001;91(7):1117–20. CrossRef
- Davis DH, et al. Early diagnosis and treatment of HIV infection: magnitude of benefit on short-term mortality is greatest in older adults. Age Ageing. 2013;42(4):520–6. CrossRef
- CDC, Racial/ethnic disparities in diagnoses of HIV/AIDS–3 states, 2001–2005. MMWR Morb Mortal Wkly Rep. 2007; 56(9):189–193.
- Fenton KA. Changing epidemiology of HIV/AIDS in the United States: implications for enhancing and promoting HIV testing strategies. Clin Infect Dis. 2007;45(Suppl 4):S213–20. CrossRef
- Klein D, et al. Review of medical encounters in the 5 years before a diagnosis of HIV-1 infection: implications for early detection. J Acquir Immune Defic Syndr. 2003;32(2):143–52. CrossRef
- Alpert PL, et al. Factors associated with unrecognized HIV-1 infection in an inner-city emergency department. Ann Emerg Med. 1996;28(2):159–64. CrossRef
- Liddicoat RV, et al. Assessing missed opportunities for HIV testing in medical settings. J Gen Intern Med. 2004;19(4):349–56. CrossRef
- Previous HIV testing among adults and adolescents newly diagnosed with HIV infection—National HIV Surveillance System, 18 jurisdictions, United States, 2006–2009. MMWR Morb Mortal Wkly Rep. 2012; 61(24):441–445.
- Blanchard JC, Haywood YC, Scott C. Racial and ethnic disparities in health: an emergency medicine perspective. Acad Emerg Med. 2003;10(11):1289–93. CrossRef
- Burt CW. IE Arispe (2004) Characteristics of emergency departments serving high volumes of safety-net patients: United States. Vital Health Stat. 2000;13(155):1–16.
- Heron SL, Stettner E, Haley LL Jr. Racial and ethnic disparities in the emergency department: a public health perspective. Emerg Med Clin North Am. 2006;24(4):905–23. CrossRef
- Oster A, Bindman AB. Emergency department visits for ambulatory care sensitive conditions: insights into preventable hospitalizations. Med Care. 2003;41(2):198–207.
- Expanded HIV testing and trends in diagnoses of HIV infection—District of Columbia, 2004–2008. MMWR Morb Mortal Wkly Rep. 2010; 59(24):737–741.
- Clauss H, et al. Prevalence and characteristics of patients with undiagnosed HIV infection in an urban emergency department. AIDS Patient Care STDS. 2011;25(4):207–11. CrossRef
- Groseclose SL, et al. Characterization of patients accepting and refusing routine, voluntary HIV antibody testing in public sexually transmitted disease clinics. Sex Transm Dis. 1994;21(1):31–5. CrossRef
- Hull HF, et al. Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic. JAMA. 1988;260(7):935–8. CrossRef
- Weinstock H, et al. Unrecognized HIV infection among patients attending sexually transmitted disease clinics. Am J Public Health. 2002;92(2):280–3. CrossRef
- Correlates of HIV Testing Refusal Among Emergency Department Patients in the Opt-Out Testing Era
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