Inaccurate documentation of HIV-positive status in adolescents visiting an urban emergency department.
OBJECTIVE
To identify the frequency of documentation of human immunodeficiency virus (HIV)-positive adolescents' serostatus during urban pediatric emergency room visits, and to examine possible differences between those whose HIV positive serostatus was and was not documented.


METHODS
Between 1986 and 1996, 115 HIV-positive adolescents (41 male, 74 female) were followed for primary medical care at the Children's National Medical Center's adolescent HIV clinic (Burgess Clinic) in Washington, DC. A retrospective chart analysis of visits to the emergency room by these adolescent patients known to be HIV positive was conducted.


RESULTS
Forty-nine of the HIV patients (ages 10-23 years) visited the hospital's emergency room a total of 124 times in the time following notification (range, 2 days to 15 years; mean, 2.6 years) of their seropositivity and joining the program. Twenty-nine of the patients had no HIV seropositivity recorded during one or more of their visits; this prevalence represents 38% of the 124 emergency room visits. Twenty of the HIV-positive emergency room patients had no seropositivity documented during any emergency department visit. Of all 124 visits, 45 involved potential health care worker exposure to the HIV virus. Diagnosis of acquired immunodeficiency syndrome, CD4 count, age, gender, and year of visit did not differ among those with and without HIV documentation.


CONCLUSIONS
Human immunodeficiency virus-positive adolescents are seen in this emergency room and their records do not reflect their infection status. These data reinforce the need for universal precautions for every patient.
Fanburg
J T
JT
Section of Adolescent and Young Adult Medicine, Children's National Medical Center, Washington, DC, USA.
D'angelo
L J
LJ
D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D000328:Adult; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D002648:Child; D003219:Confidentiality; D004219:District of Columbia / Q000453:epidemiology; D004282:Documentation / Q000592:standards*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index