title: Emergency department patient perceptions and preferences on opt-in rapid HIV screening program components.
abstract: The aim of this investigation was to assess emergency department (ED) patients' perceptions and preferences about an opt-in, universal, rapid HIV screening program and identify patient groups who expressed stronger beliefs about components of the testing program. From July 2005 to July 2006, ED patients in the opt-in, universal, rapid HIV screening program were interviewed in person. Multivariable regression models were used to compare participants on their beliefs about the program components. Of the 561 participants, 62.0% had previously been tested for HIV. The majority of participants (58.8%) believed the rapid and standard/conventional HIV tests to be equally accurate, 27.7% believed the rapid test to be less or much less accurate, and 8.7% believed the rapid test to be more or much more accurate. Almost two-thirds (65.1%) favored having a rapid instead of a standard/conventional HIV test, 94.6% wanted the test results within one hour, and 61.3% would be likely or very likely to undergo testing in the ED if it prolonged their ED visit. Almost all (92.5%) believed that their medical care was "not at all" delayed because of being tested, 94.1% believed that testing did "not at all" divert attention from the reason for their ED visit, and 80.9% thought that testing in the ED was "not at all" stressful. In multivariable logistic regression models, males and those with more than 12 years of formal education showed greater concerns about the rapid HIV test's accuracy. Hispanic/Latinos, participants with governmental insurance, and those previously HIV tested were more apt to be screened for HIV even if testing delayed their ED departure. Overall, participants were highly accepting of the components of this opt-in rapid HIV screening program. However, concerns regarding the accuracy of the rapid HIV test might limit test acceptance and should be addressed during pre-test information procedures.
authors.affiliation: Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA. rmerchant@lifespan.org
authors.forename: Roland C
authors.initials: RC
authors.lastname: Merchant
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
authors.forename: George R
authors.initials: GR
authors.lastname: Seage
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Victor G
authors.initials: VG
authors.lastname: Degruttola
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Becker
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000293:Adolescent; D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D017060:Patient Satisfaction; D013997:Time Factors; D055815:Young Adult