Chair of Pediatrics BronxCare Health System Icahn School of Medicine of Mt. Sinai Bronx, New York, United States
Background: In 2006 The CDC recommended that all patients seen in a health-care setting, 13-65 years of age, be routinely tested for HIV because early diagnosis improves personal and public health outcomes. This is in contrast to the previous paradigm of opt-in testing where testing was g offered to only high-risk populations. In 2010 the New York State Department of Health published guidelines that brought HIV testing in-line with the CDC recommendations. The purpose of these recommendations was to normalize, destigmatize and encourage Hiv testing as a routine component of health care and to increase the number of individuals being tested to promote early treatment and the identification of at risk partners. BronxCare Health System (BCHS) implemented these guidelines in 2011.
Objective: The main objective of this study was determine if a Department of Health mandated opt-out testing, as per CDC guidelines, would increase the number of individuals HIV tested among a high-risk group of adolescents and young adults seeking care at an urban community hospital.
Design/Methods: BCHS offered expedited HIV testing (EHI) using a rapid HIV-1/2 testing kit with a turnaround time of under 2 hours, and the traditional HIV-1/2 ELISA at all locations within the hospital. EHI was performed on whole blood using a third and later a fourth generation rapid HIV test. All adolescents, except in those cases where confidentialiy could not be insured, were offered testing in all clinical areas, including outpatient clinics, the Emergency Department and inpatient areas. Testing was not done only if the patient declined to be tested. This is a retrospective study that extracted demographic and clinical data from the EMR on all patients seen at this institution who had HIV testing performed from January 1, 2009 to December 31, 2019. The data was converted into a text file and uploaded into SPSS (v26). Inclusion Criteria: All patients 12 years and older who were offered an HIV test at BronxCare Health System between 2009 and 2019
Results: For 13-15 yo's the number tested went from 69138 in 2009-11 to 109727 in 2012-15 and 122835 in 2016-19. For 16-18 yo's the corresponding figures were 88766, 128300 and 129212. For 19-21 yo's the corresponding figures were 106064, 162991, and 138279. See attached graph. Conclusion(s): This study demonstrates that opt-out HIV testing significantly dramatically increased the number of adolescents and young adults receiving HIV testing at an urban community hospital.
Authors/Institutions: Peter Sherman, BronxCare Health System, Bronx, New York, United States; Murli Purswani, BronxCare Health System, Bronx, New York, United States; richard neugebauer, BronxCare Health System, Bronx, New York, United States
