title: Can computer-based feedback improve emergency department patient uptake of rapid HIV screening?
abstract: OBJECTIVE
  We determine whether (1) an audiocomputer-delivered tailored feedback intervention increases emergency department (ED) patient uptake of opt-in, nontargeted rapid HIV screening; and (2) uptake is greater among patients who report more HIV risk and among those whose self-perceived HIV risk increases from baseline after completion of an HIV risk assessment.
  
  
  METHODS
  ED patients aged 18 to 64 years were randomly assigned to receive either an assessment about reported and self-perceived HIV risk or an identical assessment plus feedback about their risk for having or acquiring an HIV infection, tailored according to their reported risk. All participants were offered a fingerstick rapid HIV test. Two-sample tests of binomial proportions were used to compare screening uptake by study arm. Multivariable logistic regression was used to assess the relationship of reported HIV risk and an increase in self-perceived HIV risk with uptake of HIV screening.
  
  
  RESULTS
  Of the 566 participants, the median age was 29 years, 62.2% were women, and 66.9% previously had been tested for HIV. Uptake of HIV screening was similar in the intervention and no intervention arms (54.1% versus 55.5% [Δ=-0.01%; 95% confidence interval {CI} -0.09% to 0.07%]). An increase in self-perceived HIV risk predicted greater uptake of HIV screening for women (odds ratio 2.15; 95% CI 1.08 to 4.28) but not men (odds ratio 1.61; 95% CI 0.60 to 4.30). Uptake of HIV screening was not related to reported HIV risk.
  
  
  CONCLUSIONS
  Uptake of rapid HIV screening in the ED was not improved by this feedback intervention. Other methods need to be investigated to improve uptake of HIV screening by ED patients.
authors.affiliation: Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Roland C
authors.initials: RC
authors.lastname: Merchant
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Langan
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: George R
authors.initials: GR
authors.lastname: Seage
authors.forename: Victor G
authors.initials: VG
authors.lastname: DeGruttola
mesh_terms: D000293:Adolescent; D000328:Adult; D003194:Computer-Assisted Instruction / Q000379:methods; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult