Routine Rapid HIV Screening in Six Community Health Centers Serving Populations at Risk
In 2006, to increase opportunities for patients to become aware of their HIV status, the Centers for Disease Control and Prevention released updated guidelines for routine, opt-out HIV screening of adults, adolescents, and pregnant women in healthcare settings. To date, there are few documented applications of these recommendations.
To measure the impact of application of the guidelines for routine screening in health centers serving communities disproportionately affected by HIV in the southeastern US.
A multi-site program implementation study, describing patients tested and not tested and assessing changes in testing frequency before and after new guidelines were implemented.
All patients aged 13 to 64 seen in participating health centers.
Routine rapid HIV screening in accord with CDC guidelines.
The frequency of testing before and after routine screening was in place and demographic differences in offering and receipt of testing.
Compared to approximately 3,000 patients in the year prior to implementation, 16,148 patients were offered testing with 10,769 tested. Of 39 rapid tests resulting in preliminary positives, 17 were newly detected infections. Among these patients, 12 of 14 receiving referrals were linked to HIV care. Nineteen were false positives. Younger patients, African Americans and Latinos were more likely to receive testing.
By integrating CDC-recommended guidelines and applying rapid test technology, health centers were able to provide new access to HIV testing. Variation across centers in offering and receiving tests may indicate that clinical training could enhance universal access.
- Centers for Disease Control and Prevention Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Morbid Mortal Wkly Rep 2006;55(RR-14):1–17.
- America’s Health Centers Fact Sheet, March 2009. Available at: http://www.nachc.org/client/documents/America’s_Health_Centers_updated_3.09.pdf. Accessed July 9, 2009.
- Weis K, Liese A, Hussey J, et al. A routine HIV screening program in a South Carolina community health center in an area of low HIV prevalence. AIDS Patient Care and STDs. 2009; 23: 251–258. CrossRef
- US Department of Health and Human Services, Office of Minority Health. National Standards for Culturally and Linguistically Appropriate Services in Health Care: Final Report, March 2001. Available at http://www.omhrc.gov/assets/pdf/checked/finalreport.pdf. Accessed July 9, 2009.
- Community Health Centers Integrate Rapid HIV Screening into Routine Primary Care, Leading to Significant Increases in Testing Rates. 2009. In AHRQ Health Care Innovations Exchange (online, April 27). Available at http://www.innovations.ahrq.gov/content.aspx?id=2445 (Accessed July 9, 2009).
- Dieffenbach C, Fauci A. Universal voluntary testing and treatment for prevention of HIV transmission. JAMA. 2009; 301: 2380–2382. CrossRef
- White DE, Warren O, Scribner AN, Frazee BW. Missed Opportunities for earlier HIV diagnosis in an emergency department despite an HIV screening program. AIDS Patient Care and STDs. 2009; 23: 245–250. CrossRef
- Walensky RP, Losina E, Steger-Craven KA, Freedberg KA. Identifying undiagnosed human immunodeficiency virus: The yield of routine, voluntary inpatient testing. Arch Intern Med. 2002; 162: 887–892. CrossRef
- Walensky RP, Losina E, Malatesta L, et al. Effective HIV case identification through routine HIV screening at urgent care centers in Massachusetts. Am J Public Health. 2005; 95: 71–73. CrossRef
- Greenwald JL, Rich CA, Bessega S, Posner MA, Maeda JL, Skolnik PR. Evaluation of the Centers for Disease Control and Prevention’s recommendations regarding routine testing for human immunodeficiency virus by an inpatient service: Who are we missing? Mayo Clin Proc. 2006; 81: 452–458. CrossRef
- Routinely recommended HIV testing at an urban urgent care clinic—Atlanta, Georgia, 2000. MMWR Morb Mortal Wkly Rep. 2001;50:538–541.
- Wesolowski LG, MacKellar DA, Facente SN, Dowling T, et al. Post-marketing Surveillance Team. Post-marketing surveillance of OraQuick whole blood and oral fluid rapid HIV testing. AIDS. 2006; 20: 1667–1668. CrossRef
- UniGold performance standards. Available at: http://www.unigoldhiv.com. Accessed July 7, 2009.
- Gray R, Makumbi F, Serwadda D, et al. Limitations of rapid HIV-1 tests during screening for trials in Uganda: diagnostic test accuracy study. BMJ. 2007; 335: 188–190. CrossRef
- Delaney K. Comparing the Performance of the APHL/CDC Proposed POC Testing Strategies and Other Potential Options Using Data from the CDC’s Evaluation of FDA Approved Rapid Tests. Paper presented at: the 2007 HIV Diagnostics conference. 2007 Dec 5–7; Atlanta, GA. Available at: http://www.hivtestingconference.org/abstracts/abstract41.pdf. Accessed July 9, 2009.
- Routine Rapid HIV Screening in Six Community Health Centers Serving Populations at Risk
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of General Internal Medicine
Volume 24, Issue 12 , pp 1269-1274
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- community health centers
- Industry Sectors
- Author Affiliations
- 1. Center for AIDS Prevention Studies, University of California, 50 Beale Street, Suite 1300, San Francisco, CA, 94105, USA
- 2. National Association of Community Health Centers, 7200 Wisconsin Ave, Suite 210, Bethesda, MD, 20814, USA