Better but not ideal acceptance of routine inpatient HIV point-of-care testing among veterans in a high prevalence area

Abstract

Background: The most recent guidance statement from The American College of Physicians recommends that clinicians adopt human immunodeficiency virus screening as part of routine medical care. Inpatient HIV testing at the Vetarns Affairs Medical Center in Washington, DC has been predominantly targeted at patients with disclosed risk factors.

Method: We implemented the first voluntary inpatient HIV testing program within a Veterans Affairs hospital using the OraQuick Advance Rapid HIV-1/2 Antibody Test on both oral secretion and whole blood samples.

Results: During a 17 month period we offered 3,467 inpatients testing and performed 824 rapid HIV tests. All reactive results were Western blot confirmed. Ten patients (1.2%) had reactive test results. Seven (0.8%) represented new HIV diagnoses, and three had been previously diagnosed outside the VA. Five patients had AIDS at the time of testing by CD4 criteria. Nine patients were linked to care and six patients were started on antiretroviral therapy. There were no false-positive results.

Conclusion: We have demonstrated how expanding HIV-POC testing among hospitalized patients can enhance patients' acceptance for screening, can detect HIV-infected individuals who might not have been tested with conventional targeted testing, and can improve linkage to care for those with HIV infection.