Prevalence of HIV infection among inpatients and outpatients in Department of Veterans Affairs health care systems: implications for screening programs for HIV.
OBJECTIVE
We sought to determine the prevalence of HIV in both inpatient and outpatient settings in 6 Department of Veterans Affairs (VA) health care sites.


METHODS
We collected demographic data and data on comorbid conditions and then conducted blinded, anonymous HIV testing. We conducted a multivariate analysis to determine predictors of HIV infection.


RESULTS
We tested 4500 outpatient blood specimens and 4205 inpatient blood specimens; 326 (3.7%) patients tested positive for HIV. Inpatient HIV prevalence ranged from 1.2% to 6.9%; outpatient HIV prevalence ranged from 0.9% to 8.9%. Having a history of hepatitis B or C infection, a sexually transmitted disease, or pneumonia also predicted HIV infection. The prevalence of previously undocumented HIV infection varied from 0.1% to 2.8% among outpatients and from 0.0% to 1.7% among inpatients.


CONCLUSIONS
The prevalence of undocumented HIV infection was sufficiently high for routine voluntary screening to be cost effective in each of the 6 sites we evaluated. Many VA health care systems should consider expanded routine voluntary HIV screening.
Owens
Douglas K
DK
VA Palo Alto Health-care System, Palo Alto, Calif, USA. owens@stanford.edu
Sundaram
Vandana
V
Lazzeroni
Laura C
LC
Douglass
Lena R
LR
Sanders
Gillian D
GD
Taylor
Kathie
K
VanGroningen
Ronald
R
Shadle
Vera M
VM
McWhorter
Valerie C
VC
Agoncillo
Teodora
T
Haren
Noreen
N
Nyland
Jill
J
Tempio
Patricia
P
Khayr
Walid
W
Dietzen
Dennis J
DJ
Jensen
Peter
P
Simberkoff
Michael S
MS
Bozzette
Samuel A
SA
Holodniy
Mark
M
D000328:Adult; D000368:Aged; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D015528:HIV Seroprevalence; D006801:Humans; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D015999:Multivariate Analysis; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000706:statistics & numerical data