OutBox

Rapid HIV Testing

By Gretchen Williams Torres, M.P.P.and Cynthia Hedges Greising

Why not take advantage of these encounters to ascertain patients’ HIV status?

The Centers for Disease Control and Prevention now recommends voluntary HIV screening of all adults and adolescents in health care settings. The new recommendations make sense. HIV testing in health care settings will directly connect HIV-infected patients to primary and specialty care.

In settings like emergency departments and labor and delivery, timing is critical and an HIV test is not the provider’s imminent concern. But an HIV test for the mother or newborn is the last opportunity to prevent transmission of HIV to the baby. As for EDs, many treat patients with minor, urgent conditions but who do not access regular primary care and will have no other opportunity to be tested. Why not take advantage of these encounters to ascertain patients’ HIV status?

There are 250,000 to 300,000 people in the United States unaware of their HIV infection. Moreover, research shows that people who know they are HIV-positive are more likely to take precautions to avoid transmitting the virus to others. And simple testing technology can provide results as quickly as 20 minutes, which helps to inform those hard-to-reach patients about their results. Many such patients are unlikely to return for results or be available for follow-up.

The Health Research & Educational Trust is partnering with the Centers for Disease Control’s Division of HIV/AIDS Prevention to examine current policies, practices and opportunities to incorporate HIV testing into hospital settings.

According to HRET surveys, almost 90 percent of hospitals are aware of rapid, point-of-care HIV testing, but only about 40 percent—mostly large, teaching hospitals—use the test. Among hospitals that use rapid tests, 41 percent use them in the ED and one-third in labor and delivery. Very few administer tests at the point of care; most use their central lab instead.

The CDC recommends easy access to rapid HIV tests to reduce the number of individuals with undiagnosed HIV infection. To promote rapid testing in hospital settings, we recommend that your organization:

Explore how to implement rapid HIV testing so more patients can be tested and linked to care.
Use rapid tests at the point of care, which will be cost-effective, save time and promote linkages to care.
Engage the hospital laboratory to address concerns about staff training in point-of-care testing and quality assurance.

Treatment advancements have improved the quality of life of people diagnosed with HIV. Implementing rapid HIV testing in health care settings will help reduce undiagnosed cases, ensuring that more people infected with HIV/AIDS can control the disease and its symptoms and enjoy longer and more active lives.

Gretchen Williams Torres, M.P.P., director, research, and Cynthia Hedges Greising, staff writer, are with the Health Research & Educational Trust, Chicago.

Contact Guest Author at cgreising@aha.org

This article 1st appeared in the December 2006 issue of HHN Magazine.

To respond to this article, please click here.