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Pilot Integration of HIV Screening and Healthcare Settings with Multi-Component Social Network and Partner Testing for HIV Detection.

Pilot Integration of HIV Screening and Healthcare Settings with Multi-Component Social Network and Partner Testing for HIV Detection.
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Rentz MF, Ruffner AH, Ancona RM, Hart KW, Kues JR, Barczak CM, Lindsell CJ, Fichtenbaum CJ, Lyons MS,


Rentz MF, Ruffner AH, Ancona RM, Hart KW, Kues JR, Barczak CM, Lindsell CJ, Fichtenbaum CJ, Lyons MS, (click to view)

Rentz MF, Ruffner AH, Ancona RM, Hart KW, Kues JR, Barczak CM, Lindsell CJ, Fichtenbaum CJ, Lyons MS,

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Current HIV research 2017 10 17() doi 10.2174/1570162X15666171017121301

Abstract
BACKGROUND
Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing ("Transmission Network Targeting (TNT)") to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT.

OBJECTIVE
To evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting.

METHODS
Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became next-generation index cases in a snowball recruitment strategy.

RESULTS
The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years.

CONCLUSIONS
TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy.

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