title: Prevalence of HIV infection among inpatients and outpatients in Department of Veterans Affairs health care systems: implications for screening programs for HIV.
abstract: 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.
authors.affiliation: VA Palo Alto Health-care System, Palo Alto, Calif, USA. owens@stanford.edu
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Owens
authors.forename: Vandana
authors.initials: V
authors.lastname: Sundaram
authors.forename: Laura C
authors.initials: LC
authors.lastname: Lazzeroni
authors.forename: Lena R
authors.initials: LR
authors.lastname: Douglass
authors.forename: Gillian D
authors.initials: GD
authors.lastname: Sanders
authors.forename: Kathie
authors.initials: K
authors.lastname: Taylor
authors.forename: Ronald
authors.initials: R
authors.lastname: VanGroningen
authors.forename: Vera M
authors.initials: VM
authors.lastname: Shadle
authors.forename: Valerie C
authors.initials: VC
authors.lastname: McWhorter
authors.forename: Teodora
authors.initials: T
authors.lastname: Agoncillo
authors.forename: Noreen
authors.initials: N
authors.lastname: Haren
authors.forename: Jill
authors.initials: J
authors.lastname: Nyland
authors.forename: Patricia
authors.initials: P
authors.lastname: Tempio
authors.forename: Walid
authors.initials: W
authors.lastname: Khayr
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Dietzen
authors.forename: Peter
authors.initials: P
authors.lastname: Jensen
authors.forename: Michael S
authors.initials: MS
authors.lastname: Simberkoff
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Bozzette
authors.forename: Mark
authors.initials: M
authors.lastname: Holodniy
mesh_terms: 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