Offering Routine, Voluntary Testing in Urban Hospitals Could Help Detect Undiagnosed HIV, Study Shows
Offering voluntary, routine HIV testing in urban hospitals can identify a significant number of individuals with undiagnosed HIV, according to a study in today's issue of the Archives of Internal Medicine. In the study, researchers from Massachusetts General Hospital, the Boston University School of Public Health and Boston Medical Center implemented the "Think HIV" program at Boston Medical Center. The program offered voluntary HIV counseling and testing to all patients admitted to the medical service of the hospital between April 1 and Dec. 31, 1999. Under the program, patients were asked by medical staff whether they were interested in speaking with someone about HIV testing. If a patient expressed interest, a voice mail message was left for a counselor. The counselor would visit the patient at the hospital, discuss HIV testing, complete pre-test counseling and conduct an HIV test. Patients who had been discharged were given outpatient appointments to receive their test results one week following the screening, and those who remained inpatients were given their results in the hospital when they became available. Patients who tested positive were referred to the HIV Diagnostic Evaluation Unit, which links HIV-positive individuals with medical care. Researchers compared the patterns in HIV testing and diagnosis during the program to a 15-month control period spanning from Jan. 1, 1998, to March 30, 1999. Before the implementation of the program, approximately 2% of all patients were referred for HIV testing and counseling, and testing was generally performed on patients with one or more "clear risks for and/or signs of HIV infection." Patients admitted during the program period were 3.4 times more likely to get tested for HIV than those admitted during the control period. In addition, patients who were tested during the program, who likely would not have been otherwise screened, had an estimated HIV infection rate of 3.8%. The Think HIV program detected approximately two new HIV infections per month, while only one infection per month was identified during the control period. The researchers conclude that suggesting HIV testing only to patients who have symptoms of HIV is "inadequate" to identify the 33% of HIV-positive Americans who have not been screened for the virus (Walensky et al., Archives of Internal Medicine, 4/22).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.