Keenan PA; National HIV Prevention Conference (2003 : Atlanta, Ga.).
Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003 Hyatt Regency Atlanta Hotel Atlanta Ga Natl HIV Prev Conf 2003 Atlanta Ga. 2003; abstract no. TP-063.
Univ. of MN, Dept FP and Comm. Health, Minneapolis, MN
ISSUE: Routine HIV testing in acute care settings (urgent care, emergency rooms) has been shown to be an effective means of finding new HIV patients at an earlier stage of their disease process. It has also led to a higher percentage of newly diagnosed cases accessing medical care.SETTING: Minnesota is a state with a low to moderate rate of HIV/ AIDS infection. However, there are significant racial and geographic disparities. In 2000 African Americans had new-onset HIV infections that was 20 times higher than whites. Minneapolis accounted for almost half of new HIV cases. Our clinic is located in North Minneapolis, a predominantly African American community.PROJECT: The objective of our project was to promote "routine" HIV testing. We used multiple interventions. We defined routine testing to mean testing of sexually active patients between ages 12 to 50. First, we hired a half-time LPN who received training in HIV prevention. She was empowered to talk with patients about HIV prevention as they waited for their physicain in the exam room. She counseled them on the advantages of knowing HIV serostatus. Second, we offered "user friendly" means of HIV testing, including urine and oral fluid testing. Third, we publicized the project to staff and patients. We held held inservices on HIV prevention for provider and nursing staff. The front desk gave each patient a small card advising them the clinic advocated routine HIV testing and that we used convenient, non-invasive testing. We put up similar notices within the clinic.RESULTS: We compared the number of HIV tests done at our clinic during the 6 months of the project with the number of tests done during the same 6 months of the year before. The total number of patients seen during this time did not significantly change. We excluded antenatal HIV tests since we were already doing routine obstetric HIV testing. During the 5 months of the project non- obstetric HIV tests increased fom 298 to 493 (65% increase). We found three new cases of HIV. All went on to access medical care.LESSONS LEARNED: Significant barriers were encountered. Administration was concerned because of the higher cost of urine and oral fluid HIV testing. Because of HIV stigma, front desk persons were sometimes hesitant to hand out cards. Laboratory personnel were initially not accepting of the change. They were required to learn oral fluid testing and to send specimens to a different reference laboratory. Providers were hesitant to use the oral fluid test because of quality concerns. They also often felt they did not have time to routinely address HIV prevention. Interestingly, patients did not object to being contacted by the HIV prevention specialist as they waited in the exam room. A few patients were initially concerned that they had been "singled out" for HIV prevention discussion but were felt better when the HIV prevention specialist reassured them HIV prevention was "routine" at our clinic. The project succeeded in increasing the number of HIV tests and finding 3 new cases.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Counseling
- HIV Infections
- HIV Seropositivity
- Humans
- Mass Screening
- Minnesota
Other ID:
UI: 102262170
From Meeting Abstracts