Risk, reasons for refusal, and impact of counseling on consent among ED patients declining HIV screening - 06/08/11
, Christopher J. Lindsell, PhD a , Dana L. Raab, RN a , Andrew H. Ruffner a , Alexander T. Trott, MD a , Carl J. Fichtenbaum, MD b , Michael S. Lyons, MD a, ⁎ Abstract |
Screening for HIV in the emergency department (ED) is recommended by the Centers for Disease Control and Prevention. The relative importance of efforts to increase consent among those who currently decline screening is not well understood. We compared the risk characteristics reported by patients who decline risk-targeted, opt-in ED screening with those who consent. We secondarily recorded reasons for declining testing and reversal of the decision to decline testing after prevention counseling. Of 199 eligible patients, 106 consented to testing and 93 declined. Of those declining, 60 (64.5%) of 93 completed a risk assessment. There were no differences in HIV risk behaviors between groups. Declining patients reported recent testing in 73.3% of cases. After prevention counseling, 4 (6.7%) of 60 who initially declined asked to be tested. Given similarities between those who decline and those who consent to testing, efforts to increase consent may be beneficial. However, this should be tempered by the finding that many declined because of a recent negative test. Emphasizing risk during prevention counseling is not a promising strategy for improving opt-in consent rates.
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| ☆ | Financial support: The clinical program described in this report was supported by the Ohio Department of Health and the Cincinnati Health Network. The research was supported in part by K23AI068453 from the National Institute of Allergy and Infectious Diseases. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health. |
| ☆☆ | Presentation: This study was presented at the 2008 National Summit on HIV Prevention, Diagnosis, and Access to Care in Arlington, VA, in November 2008. |
Vol 29 - N° 4
P. 367-372 - mai 2011 Retour au numéro
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