HIV Testing in the Emergency Department at Baystate Medical Center: A Pilot Program

NCT00987194 | Completed

• 1 other identifier: IRB09-012
• Study Type: observational
• Target: 1,087
• Locations: 1 country
• Sites: 1

Brief Summary

Background Recently, the CDC issued recommendations calling for HIV screening for patients aged 13-64, when the individual accesses the health care system. For many patients, the emergency department (ED) is the primary or only contact point for health care. The rapid HIV test can be done as a point of care test in the ED. Study Objectives A. Primary: 1\. To initiate HIV testing in the Baystate ED. B. Secondary:

1. 1.To estimate the resources involved in initiating a rapid HIV testing program in the ED.
2. 2.To describe the process of initiating a rapid HIV testing program.
3. 3.To compare the yield of testing for HIV in patients with known HIV risk factors compared to those without known risk factors.
4. 4.To describe the characteristics of the population tested for HIV in the ED.
5. 5.To determine the number of patients who declined testing and the reasons for declining testing.
6. 6.To analyze ED staff attitudes re: HIV rapid testing in the ED.

Conditions

HIV Infections

Keywords

HIV; rapid testing; HIV seronegativity

Outcome Measures

Primary Outcomes (1)

• The feasibility of initiating a rapid HIV testing program in the emergency department of a community teaching hospital in an a medium size city.

  2 years

Secondary Outcomes (1)

• To determine the number of newly diagnosed individuals who were successfully linked to an HIV provider and the number who received antiretroviral therapy within one year of initial diagnosis.

  2 years

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Emergency department patients aged 18 years or older

You may qualify if:

• Emergency department patients aged 18 years or older, appropriate for HIV testing will be identified by the HIV health educator.
• Patients who are not otherwise occupied and who are not known to be HIV+ will be approached for consent to the study and for rapid HIV testing.

You may not qualify if:

• None.

Sponsors & Collaborators

• Baystate Medical Center: lead
• Massachusetts Department of Health: collaborator

Study Sites (1)

Baystate Medical Center

Springfield, Massachusetts, 01199, United States

Location

Related Publications (12)

• Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, Clark JE; Centers for Disease Control and Prevention (CDC). Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006 Sep 22;55(RR-14):1-17; quiz CE1-4.

  PMID: 16988643 BACKGROUND

• Palella FJ Jr, Deloria-Knoll M, Chmiel JS, Moorman AC, Wood KC, Greenberg AE, Holmberg SD; HIV Outpatient Study Investigators. Survival benefit of initiating antiretroviral therapy in HIV-infected persons in different CD4+ cell strata. Ann Intern Med. 2003 Apr 15;138(8):620-6. doi: 10.7326/0003-4819-138-8-200304150-00007.

  PMID: 12693883 BACKGROUND

• Keiser P, Nassar N, Kvanli MB, Turner D, Smith JW, Skiest D. Long-term impact of highly active antiretroviral therapy on HIV-related health care costs. J Acquir Immune Defic Syndr. 2001 May 1;27(1):14-9. doi: 10.1097/00126334-200105010-00003.

  PMID: 11404515 BACKGROUND

• Centers for Disease Control and Prevention (CDC). False-positive oral fluid rapid HIV tests--New York City, 2005-2008. MMWR Morb Mortal Wkly Rep. 2008 Jun 20;57(24):660-5.

  PMID: 18566566 BACKGROUND

• Hutchinson AB, Branson BM, Kim A, Farnham PG. A meta-analysis of the effectiveness of alternative HIV counseling and testing methods to increase knowledge of HIV status. AIDS. 2006 Aug 1;20(12):1597-604. doi: 10.1097/01.aids.0000238405.93249.16.

  PMID: 16868440 BACKGROUND

• Lubelchek R, Kroc K, Hota B, Sharief R, Muppudi U, Pulvirenti J, Weinstein RA. The role of rapid vs conventional human immunodeficiency virus testing for inpatients: effects on quality of care. Arch Intern Med. 2005 Sep 26;165(17):1956-60. doi: 10.1001/archinte.165.17.1956.

  PMID: 16186464 BACKGROUND

• Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):446-53. doi: 10.1097/01.qai.0000151079.33935.79.

  PMID: 16010168 BACKGROUND

• Holtgrave DR. Costs and consequences of the US Centers for Disease Control and Prevention's recommendations for opt-out HIV testing. PLoS Med. 2007 Jun;4(6):e194. doi: 10.1371/journal.pmed.0040194.

  PMID: 17564488 BACKGROUND

• Bogart LM, Howerton D, Lange J, Setodji CM, Becker K, Klein DJ, Asch SM. Provider-related barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs) and hospitals. AIDS Behav. 2010 Jun;14(3):697-707. doi: 10.1007/s10461-008-9456-3. Epub 2008 Sep 3.

  PMID: 18770022 BACKGROUND

• Ehrenkranz PD, Ahn CJ, Metlay JP, Camargo CA Jr, Holmes WC, Rothman R. Availability of rapid human immunodeficiency virus testing in academic emergency departments. Acad Emerg Med. 2008 Feb;15(2):144-50. doi: 10.1111/j.1553-2712.2008.00028.x.

  PMID: 18275444 BACKGROUND

• Centers for Disease Control and Prevention (CDC). Missed opportunities for earlier diagnosis of HIV infection--South Carolina, 1997-2005. MMWR Morb Mortal Wkly Rep. 2006 Dec 1;55(47):1269-72.

  PMID: 17136020 BACKGROUND

• Rothman RE, Ketlogetswe KS, Dolan T, Wyer PC, Kelen GD. Preventive care in the emergency department: should emergency departments conduct routine HIV screening? a systematic review. Acad Emerg Med. 2003 Mar;10(3):278-85. doi: 10.1111/j.1553-2712.2003.tb02004.x.

  PMID: 12615596 BACKGROUND

MeSH Terms

Conditions

HIV Infections

Condition Hierarchy (Ancestors)

Blood-Borne Infections; Communicable Diseases; Infections; Sexually Transmitted Diseases, Viral; Sexually Transmitted Diseases; Lentivirus Infections; Retroviridae Infections; RNA Virus Infections; Virus Diseases; Genital Diseases; Urogenital Diseases; Immunologic Deficiency Syndromes; Immune System Diseases

Study Officials

• Daniel J Skiest, MD

  Baystate Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: September 25, 2009
• First Posted: September 30, 2009
• Study Start: March 1, 2009
• Primary Completion: March 1, 2010
• Study Completion: March 1, 2010
• Last Updated: July 14, 2010

Record last verified: 2010-07

Locations

US (1)