title: A model for routine hospital-wide HIV screening: lessons learned and public health implications.
abstract: BACKGROUND
  Approximately 232700 (21%) of Americans are unaware of their HIV-seropositive status; this represents a potential for virus transmission. Revised recommendations from the Centers for Disease Control for HIV screening promote routine screening in the health care setting. We describe the implementation of a hospital-wide routine HIV screening program in the District of Columbia.
  
  
  METHODS
  Rapid HIV testing was conducted at Howard University Hospital on consenting patients at least 18 years of age using the OraSure OraQuick Advance Rapid HIV-1/2 Antibody Test. The study population includes Howard University Hospital patients who were offered HIV screening over a 12-month period at no cost. Screened patients received immediate test results and, for those patients found to be preliminarily reactive, confirmatory testing and linkage to care were offered.
  
  
  RESULTS
  Of the 12836 patients who were offered testing, 7528 (58.6%) consented. Preliminary reactive test results were identified in 176 patients (2.3%). Overall, 45.5% were confirmed, of which 82.5% were confirmed positive. Screening protocol changes have led to 100% confirmation since implementation.
  
  
  CONCLUSIONS
  Hospital-wide routine HIV screening is feasible and can be implemented effectively and efficiently. The HIV screening campaign instituted at Howard University Hospital identified a substantial number of HIV-positive individuals and provided critical connection to follow-up testing, counseling, and disease management services.
authors.affiliation: Women's Health Institute, Howard University, 2041 Georgia Ave NW, Ste 6000, Washington, DC 20060, USA. cmaxwell@howard.edu
authors.forename: Celia J
authors.initials: CJ
authors.lastname: Maxwell
authors.forename: Amy M
authors.initials: AM
authors.lastname: Sitapati
authors.forename: Sayyida S
authors.initials: SS
authors.lastname: Abdus-Salaam
authors.forename: Victor
authors.initials: V
authors.lastname: Scott
authors.forename: Marsha
authors.initials: M
authors.lastname: Martin
authors.forename: Maya E
authors.initials: ME
authors.lastname: Holt-Brockenbrough
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Retland
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D017146:Models, Organizational; D015980:Public Health Practice