, Volume 24, Issue 12, pp 1269-1274,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 05 Aug 2009

Routine Rapid HIV Screening in Six Community Health Centers Serving Populations at Risk

Abstract

Background

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.

Objective

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.

Design

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.

Participants

All patients aged 13 to 64 seen in participating health centers.

Interventions

Routine rapid HIV screening in accord with CDC guidelines.

Measurements

The frequency of testing before and after routine screening was in place and demographic differences in offering and receipt of testing.

Main Results

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.

Conclusions

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.

An erratum to this article can be found at http://dx.doi.org/10.1007/s11606-009-1138-y