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. 2018 May 2;66(10):1581-1587.
doi: 10.1093/cid/cix1053.

Expanding Hospital Human Immunodeficiency Virus Testing in the Bronx, New York and Washington, District of Columbia: Results From the HPTN 065 Study

Bernard M Branson  1 , Pollyanna R Chavez  1 , Brett Hanscom  2 , Elizabeth Greene  3 , Laura McKinstry  2 , Kate Buchacz  1 , Geetha Beauchamp  2 , Theresa Gamble  2 , Barry S Zingman  4 , Edward Telzak  5 , Tammey Naab  6 , Lisa Fitzpatrick  7 , Wafaa M El-Sadr  8 ; HIV Prevention Trials Network (HPTN) 065 Study Team
Affiliations

Expanding Hospital Human Immunodeficiency Virus Testing in the Bronx, New York and Washington, District of Columbia: Results From the HPTN 065 Study

Bernard M Branson et al. Clin Infect Dis. .

Abstract

Background: Human immunodeficiency virus (HIV) testing is critical for both HIV treatment and prevention. Expanding testing in hospital settings can identify undiagnosed HIV infections.

Methods: To evaluate the feasibility of universally offering HIV testing during emergency department (ED) visits and inpatient admissions, 9 hospitals in the Bronx, New York and 7 in Washington, District of Columbia (DC) undertook efforts to offer HIV testing routinely. Outcomes included the percentage of encounters with an HIV test, the change from year 1 to year 3, and the percentages of tests that were HIV-positive and new diagnoses.

Results: From 1 February 2011 to 31 January 2014, HIV tests were conducted during 6.5% of 1621016 ED visits and 13.0% of 361745 inpatient admissions in Bronx hospitals and 13.8% of 729172 ED visits and 22.0% of 150655 inpatient admissions in DC. From year 1 to year 3, testing was stable in the Bronx (ED visits: 6.6% to 6.9%; inpatient admissions: 13.0% to 13.6%), but increased in DC (ED visits: 11.9% to 15.8%; inpatient admissions: 19.0% to 23.9%). In the Bronx, 0.4% (408) of ED HIV tests were positive and 0.3% (277) were new diagnoses; 1.8% (828) of inpatient tests were positive and 0.5% (244) were new diagnoses. In DC, 0.6% (618) of ED tests were positive and 0.4% (404) were new diagnoses; 4.9% (1349) of inpatient tests were positive and 0.7% (189) were new diagnoses.

Conclusions: Hospitals consistently identified previously undiagnosed HIV infections, but universal offer of HIV testing proved elusive.

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Figures

Figure 1.
Figure 1.
Absolute difference from year 1 to year 3 in the percentage of tests conducted during emergency department visits and inpatient admissions, by hospital, 2011–2014. *Denotes significant change in percentage tested of ≥5%. Abbreviations: Bronx, Bronx, New York; DC, Washington, District of Columbia; HIV, human immunodeficiency virus.
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