Implementing an HIV and Sexually Transmitted Disease Screening Program in an Emergency Department - 16/08/11
, Nancy R. Glick, MD b, Sheryl B. Lyss, PhD, MPH c, Angela B. Hutchinson, PhD, MPH c, Thomas L. Gift, PhD c, Lisa N. Pealer, PhD c, d, Dawn Broussard, MPH e, Steven Whitman, PhD a
Reprints not available from the authors. Address for correspondence: Abigail Silva, MPH, Sinai Urban Health Institute, Sinai Health System California at 15th Street, K436, Chicago, IL 60608; 773-257-5785, fax 773-257-5680Résumé |
Study objective |
We assess the feasibility, effectiveness, and cost of routinely recommended HIV/sexually transmitted disease screening in an urban emergency department (ED).
Methods |
From April 2003 to August 2004, patients aged 15 to 54 years were offered rapid HIV testing, and those aged 15 to 25 years were also offered gonorrhea and chlamydia testing (nucleic acid amplification), Monday through Friday, 11 am to 8 pm. Infected patients were referred for treatment and care. Prevalence, treatment rates, and cost were assessed.
Results |
Among 3,030 patients offered HIV testing, 1,447 (47.8%) accepted, 8 (0.6%) tested positive, and 3 (37.5%) were linked to care. Among 791 patients offered sexually transmitted disease testing, 386 (48.8%) accepted, 320 provided urine (82.9%), 48 (15.0%) tested positive, and 42 (87.5%) were treated for gonorrhea or chlamydia. The program cost was $72,928. Costs per HIV-infected patient identified and linked to care were, respectively, $9,116 and $24,309; cost per sexually transmitted disease–infected patient treated was $1,736. The program cost for HIV/sexually transmitted disease screening was only $14,340 more than if we screened only for HIV.
Conclusion |
Through ED-based HIV/sexually transmitted disease screening, we identified and treated many sexually transmitted disease–infected patients but identified few HIV-infected patients and linked even fewer to care. However, sexually transmitted disease screening can be added to HIV screening at a reasonable cost.
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| Supervising editor: Arthur L. Kellermann, MD, MPH |
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| Author contributions: AS, NRG, SL, LNP, and DB contributed significantly to the study concept and design. AS and NRG drafted the article. AS oversaw data collection and analyzed the data. ABH and TLG analyzed the time-motion data and drafted the cost analysis. NRG, SL, LNP, and SW critically revised the manuscript. AS takes responsibility for the paper as a whole. |
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| Funding and support: This work was funded through a Cooperative Agreement (R18/CCR520998-01) with the National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA. |
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| Available online November 20, 2006. |
Vol 49 - N° 5
P. 564-572 - mai 2007 Retour au numéro
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- Measuring Antibiotic Timing for Pneumonia in the Emergency Department: Another Nail in the Coffin
- Jesse M. Pines
- To Test or Not To Test? HIV, Emergency Departments, and the New Centers for Disease Control and Prevention Guidelines
- Keith Thomas Borg
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