title: Assessment of emergency department health care professionals' behaviors regarding HIV testing and referral for patients with STDs.
abstract: The objective of this study was to evaluate human immunodeficiency virus (HIV) counseling, testing, and referral practices of emergency department health care professionals (i.e., medical doctors [MD], physician assistants [PA], nurse practitioners [NP], and registered nurses [RN]) for patients presenting with other sexually transmitted diseases (STD). All health care professionals from 10 emergency departments in a northeastern county were asked to complete an anonymous survey. The surveys were returned by 154 (41%) health care professionals (RN = 99, NP = 5, PA = 7, MD = 39, other = 4). The average years in practice were 11. Only 7% of respondents were certified to provide state mandated HIV pretest counseling (certification not required for MD). Respondents reported caring for an average of 13 patients per week with suspected STD. Fifty-five percent of respondents reported that they always or usually warn STD patients of their HIV risk, yet only 10% always or usually encouraged these patients to consent to HIV testing in their emergency department (RN = 7%, NP = 25%, PA = 0%, MD = 16%). Reasons for not offering HIV testing in their emergency department were follow-up concerns (51%), not certified to provide pretest/posttest counseling (45%), and too time consuming (19%). Twenty-seven percent of respondents indicated HIV testing was not available in their emergency department despite all hospital laboratories reporting HIV testing capability. Ninety-three percent of respondents were aware that confidential testing sites were available, but only 35% always or usually referred patients not tested in the emergency department elsewhere for testing. Emergency department health care professionals frequently fail to provide HIV counseling, testing, and/or referral for patients with suspected STD.
authors.affiliation: Daemen College School of Nursing, Department of Emergency Medicine, University at Buffalo, State University of New York, Buffalo, New York, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fincher-Mergi
authors.forename: Kathy Jo
authors.initials: KJ
authors.lastname: Cartone
authors.forename: Jean
authors.initials: J
authors.lastname: Mischler
authors.forename: Patricia
authors.initials: P
authors.lastname: Pasieka
authors.forename: E Brooke
authors.initials: EB
authors.lastname: Lerner
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Billittier
mesh_terms: D003376:Counseling; D015658:HIV Infections / Q000175:diagnosis*; D006282:Health Personnel; D006801:Humans; D011364:Professional Practice; D012017:Referral and Consultation; D018570:Risk Assessment; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000628:therapy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires