2009 Southern Regional Meeting Abstracts
Session: SSGIM Research Abstract Session B
ACHIEVING UNIVERSAL HIV SCREENING-PREDICTORS OF WHAT INFLUENCES SCREENING
Martinez J1, Stefan M2, Crawford K3, Su SW4, Modak I5. 1Weill Cornell Medical Cntr, NY, NY; 2Baystate Medical Cntr, Springfield, MA; 3Moses Cone Health System, Greensboro, NC; 4Mount Vernon Hospital, NY, NY and 5Methodist Dallas Medical Cntr, Dallas, TX.
Purpose of Study: Over 1,000,000 persons in the US are living with HIV/AIDS, with 24% unaware of their HIV status. In 2006, the CDC recommended universal HIV screening. However it remains unclear who is being routinely screened for HIV. This study seeks to evaluate the characteristics of patients that are being tested compared to who are not.
Methods Used: Patients were recruited from 8 academic internal medicine clinics. Patients were eligible if they were 18-64 years old, fluent in English or Spanish and received continuity care at the clinic. Participants completed a 76 item survey which assessed demographics, HIV risk factors, knowledge, beliefs, attitudes and characteristics of patient-MD interactions. An HIV knowledge score was generated. Descriptive statistics were complied. Bivariate analyses were performed and variables with a p-value of <0.1 were included in a logistic regression model to determine characteristics most associated with HIV screening.
Summary of Results: From the 404 patients who completed the surveys 60% (218 patients) reported being screened for HIV. 68% were female, mean age was 45.3, and majority was of ethnic minorities (67%). In the bivariate analyses, MD recommendation (93% of those tested), patient’s own request (95%), younger age (mean age 43 for those tested), more knowledge about HIV and HIV screening, knowing someone with HIV (69%), agreement with CDC recommendations (86%), being comfortable with their doctor (88%), using street drugs in less than 5ys (82%) were strongly associated with testing. In logistic regression, MD recommendation (OR 5.36), if they knew someone with HIV (OR 2.68), agreement with the CDC recommendations (OR 5.1) and patients’ asking for the test (OR 53.6) remained significant.
Conclusions: Although per the 2006 recommendations all patients in our cohort should have been screened for HIV, only 60% reported being screened. This rate is far better than past reports. Our data suggest that a patient request is the strongest predictor of HIV screening. Therefore, simple waiting room prompts and public education campaigns may represent the most efficient interventions to approach CDC universal HIV screening goals.
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