A COMPARISON OF HIV TESTING IN THE EMERGENCY DEPARTMENT AND URGENT CARE

被引:9
作者
White, Douglas A. E. [1 ]
Cheung, Paul T. [1 ]
Scribner, Alicia N. [1 ]
Frazee, Bradley W. [1 ]
机构
[1] Highland Hosp, Alameda Cty Med Ctr, Dept Emergency Med, Oakland, CA 94602 USA
关键词
rapid HIV testing; emergency medicine; AIDS; screening; urgent care; MISSED OPPORTUNITIES; EXPERIENCE; INFECTION;
D O I
10.1016/j.jemermed.2009.04.068
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Although national guidelines recommend universal human immunodeficiency virus (HIV) testing, emergency departments (EDs) may choose to limit testing to certain patients, such as those triaged to urgent care (UC). Objective: To compare the results of rapid HIV testing in an urban ED with an affiliated UC. Methods: This was a retrospective analysis of an HIV testing program that included screening, which was initiated by triage nurses, and diagnostic testing, which was initiated by clinicians. Eligible patients were >= 12 years old and medically stable. Results: From April 2005 through December 2006, HIV tests were completed in 6196 (8.3%) of the 74,331 ED visits and 3256(8.8%) of the 37,169 UC visits. Screening accounted for 5009 (80.8%) of the ED tests and 2914 (89.5%) of the UC tests, and diagnostic testing accounted for the remainder. Eighty (1.3%) of the ED tests and 21 (0.6%) of the UC tests were positive (p = 0.0024). Compared with newly diagnosed HIV-positive ED patients, HIV-positive UC patients were less likely to have CD4 counts < 200 cells/mu L (adjusted odds ratio 0.19, 95% confidence interval 0.05-0.65). Conclusion: Although the yield of HIV testing is greater among ED patients, UC patients are diagnosed at a less advanced stage of illness. (C) 2010 Elsevier Inc.
引用
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页码:521 / 528
页数:8
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