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HIV Screening in the ED

HIV Screening in the ED

The CDC and other agencies have emphasized that EDs should offer HIV screening because of their high patient volume and access to vulnerable populations, says Michael S. Lyons, MD, MPH. “The problem, however, is that EDs are already overburdened and many don’t have the dedicated resources they need to increase testing rates.” Efforts to increase ED HIV screening are growing, but controversy persists about who should be tested. HIV screening has been advocated to detect as many cases as possible, but this requires many tests and brings concerns about feasibility and effectiveness. The alternative—selectively targeting screening only to those at higher risk—may increase the chances that a test will be positive and require fewer tests, but studies show that this approach often misses cases. Prior failures in targeting may have been due to incomplete implementation or overly narrow selection criteria. Comparing Approaches Dr. Lyons and colleagues conducted a study, published in JAIDS, comparing the efficacy of universal and targeted screening in the context of an opt-in ED HIV screening program. In the attempt to overcome concerns about the inadequacy of targeted screening, the authors tested and implemented an exceedingly comprehensive approach to targeting—for example, any possible indication of increased risk could trigger a test offer—and implemented the strategy fully. The study assessed 9,572 visits during which patients were approached for either targeted or universal screening. For universal screening, 40.8% consented but just 0.3% were newly diagnosed with HIV. For targeted screening, 47.4% of patients who had HIV testing indications consented but just 0.2% were newly diagnosed with HIV. “Ultimately,” Dr. Lyons says, “using this targeted screening strategy was unlikely...
CDC Taps Pri-Med to Educate Physicians on HIV Screening

CDC Taps Pri-Med to Educate Physicians on HIV Screening

The Centers for Disease Control and Prevention (CDC) has chosen Pri-Med, parent company to Physician’s Weekly, to educate and inform thousands of primary care physicians on strategies to employ routine HIV screening and diagnosis in primary care practice, a component of the CDC’s broader Act Against AIDS campaign. The education program, “HIV Screening for Patients: 13-64: A Guide for Primary Care Providers,” provides an open dialogue among clinician experts and primary care physicians on how to simplify routine HIV screening in practice and incorporate new technologies in HIV testing. According to the CDC’s 2006 Revised Recommendations for HIV Testing for adults, adolescents, and pregnant women in the health care setting, the CDC recommends routine HIV screening in healthcare settings for all patients 13-64 years old. Studies indicate that approximately 20% of people with HIV are unaware of their HIV status, making them much more likely to transmit the virus to others. Primary care physicians play a pivotal role in fighting the HIV epidemic on the front lines through the adoption of routine screening in practice. So far this year the program has been held in Fort Lauderdale and Philadelphia, and additional sessions are being considered for this fall. Cities are selected based on disease prevalence. To expand upon the educational experience, representatives from the CDC make themselves available on-site to provide additional tools and resources for incorporating HIV testing into primary care settings. Pri-Med is a leading provider of professional education solutions to a community of more than 248,000 primary care clinicians. For more information about Pri-Med visit...
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