Availability of rapid human immunodeficiency virus testing in academic emergency departments
Availability of rapid human immunodeficiency virus testing in academic emergency departments
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DOI：
10.1111/j.1553-2712.2008.00028.x
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发表时间：
2008-02-01
影响因子：
4.4
通讯作者：
Rothman, Richard
中科院分区：
文献类型：
--
作者：
Ehrenkranz, Peter D.;Ahn, Christina J.;Rothman, Richard
目的：疾病控制和预防中心（CDC）建议对13至64岁的急诊科（艾德）患者进行常规人类免疫缺陷病毒（HIV）筛查。该研究的目的是确定学术ED的快速艾滋病毒检测的可及性，以确定影响艾德的通过测试的因素，并描述目前的艾滋病毒检测practice.Methods：在线调查被发送到急诊医学（EM）住院计划（n = 128），不包括联邦医院和设施在美国领土的ED附属。80%（n = 102）回答。大多数的电子邮件收件人（n = 121）是急诊医学网络（EMNet）的调查人员，其余的联系人从住宅相关的Web sites.Results：大多数学术ED（n = 58; 57%; 95%置信区间（CI）= 47%至66%）提供快速的HIV检测。在这一组中，26个（45%）允许提供者无限制地订购测试。在其他32个急诊室中，100%的急诊室有允许在职业暴露后进行快速艾滋病毒检测的政策，但只有不到10%的急诊室有在其他临床情况下进行检测的指导方针。47%的人希望在未来2到3年内定期提供艾滋病毒检测。在任何情况下提供快速检测的急诊室中，只有59%的急诊室可以将艾滋病毒阳性患者与专科护理联系起来。设施的特点最重要的快速艾滋病毒检测的可用性是现场的艾滋病毒counsellers.Conclusions的存在：大多数学术ED现在提供快速的艾滋病毒检测（57%），但很少使用它在职业暴露以外的情况。不到一半的学术ED希望在未来几年内实施CDC关于常规筛查的指导方针。作者确定了设施特征（例如，咨询，转介能力），这可能会影响采用快速艾滋病毒检测。
Objectives: The Centers for Disease Control and Prevention (CDC) recommends routine human immunodeficiency virus (HIV) screening of emergency department (ED) patients aged 13 to 64 years. The study objectives were to determine the accessibility of rapid HIV testing in academic EDs, to identify factors that influence an ED's adoption of testing, and to describe current HIV testing practices.Methods: Online surveys were sent to EDs affiliated with emergency medicine (EM) residency programs (n = 128), excluding federal hospitals and facilities in U.S. territories. Eighty percent (n = 102) responded. Most e-mail recipients (n = 121) were Emergency Medicine Network (EMNet) investigators; remaining contacts were obtained from residency-related Web sites.Results: Most academic EDs (n = 58; 57%; 95% confidence interval (CI) = 47% to 66%) offer rapid HIV testing. Among this group, 26 (45%) allow providers to order tests without restrictions. Of the other 32 EDs, 100% have policies allowing for rapid HIV testing following occupational exposures, but less than 10% have guidelines for testing in other clinical situations. Forty-seven percent expect to routinely offer HIV testing in the next 2 to 3 years. Only 59% of the EDs that offered rapid tests in any situation could link an HIV-positive patient to subspecialty care. The facility characteristic most important to availability of rapid HIV testing was the presence of on-site HIV counselors.Conclusions: Most academic EDs now offer rapid HIV testing (57%), but few use it in situations other than occupational exposure. Less than half of academic EDs expect to implement CDC guidelines regarding routine screening within the next few years. The authors identified facility characteristics (e.g., counseling, ability to refer) that may influence adoption of rapid HIV testing.