title: HIV screening practices and hospital characteristics in the US, 2009-2010.
abstract: OBJECTIVE
  The Centers for Disease Control and Prevention recommends HIV screening in U.S. health-care settings unless providers document a yield of undiagnosed HIV infections of <1 per 1,000 population. However, implementation of this guidance has not been widespread and little is known of the characteristics of hospitals with screening practices in place. We assessed how screening practices vary with hospital characteristics.
  
  
  METHODS
  We used a national hospital survey of HIV testing practices, linked to HIV prevalence for the county, parish, borough, or city where the hospital was located, to assess HIV screening of some or all patients by hospitals. We used multivariate logistic regression analysis to assess the association between screening practices and hospital characteristics that were significantly associated with screening in bivariate analyses.
  
  
  RESULTS
  Of 376 hospitals in areas of prevalence ≥0.1%, only 25 (6.6%) reported screening all patients for HIV and 131 (34.8%) reported screening some or all patients. Among 638 hospitals included, screening some or all patients was significantly (p<0.05) more common at teaching hospitals, hospitals with higher numbers of annual admissions, and hospitals with a high proportion of Medicaid admissions. In multivariable analysis, screening some or all patients was independently associated with admitting more than 15% of Medicaid patients and receiving resources or reimbursement for screening tests.
  
  
  CONCLUSIONS
  We found that few hospitals surveyed reported screening some or all patients, and failure to screen is common across all types of hospitals in all regions of the country. Expanded reimbursement for screening may increase compliance with the recommendations.
authors: Health Research and Educational Trust, Chicago, IL 60606, USA. jherrin@aha.org
authors: Jeph
authors: J
authors: Herrin
authors: Laura G
authors: LG
authors: Wesolowski
authors: James D
authors: JD
authors: Heffelfinger
authors: Nathan
authors: N
authors: Bostick
authors: H Irene
authors: HI
authors: Hall
authors: Steven F
authors: SF
authors: Ethridge
authors: Bernard M
authors: BM
authors: Branson
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D002487:Centers for Disease Control and Prevention, U.S.; D003430:Cross-Sectional Studies; D019983:Guideline Adherence; D006678:HIV; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006306:Health Surveys; D006761:Hospitals / Q000145:classification / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000592:standards* / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D015995:Prevalence; D014481:United States / Q000453:epidemiology
references: MMWR Morb Mortal Wkly Rep. 2011 Jun 3;60(21):689-93
references: 21637182
references: N Engl J Med. 1998 Mar 26;338(13):853-60
references: 9516219
references: JAMA. 2011 May 4;305(17):1767-8
references: 21540419
references: J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):446-53
references: 16010168
references: Ann Emerg Med. 2011 Jul;58(1 Suppl 1):S23-7
references: 21684403
references: Public Health Rep. 2009 May-Jun;124(3):400-8
references: 19445416
references: Lancet. 1998 Nov 28;352(9142):1725-30
references: 9848347
references: AIDS. 2007 Jul 31;21(12):1617-24
references: 17630557
references: JAMA. 1998 Nov 4;280(17):1497-503
references: 9809730
references: Ann Intern Med. 1999 Apr 6;130(7):570-7
references: 10189326
references: J Infect Dis. 2006 Jul 1;194(1):11-9
references: 16741877
references: Public Health Rep. 2012 Sep-Oct;127(5):524-31
references: 22942470
references: AIDS Patient Care STDS. 2011 Nov;25(11):647-55
references: 22023315
references: MMWR CDC Surveill Summ. 1999 Apr 16;48(2):1-22
references: 12412613
references: MMWR Recomm Rep. 2006 Sep 22;55(RR-14):1-17; quiz CE1-4
references: 16988643
references: J Acquir Immune Defic Syndr. 2010 Jan;53(1):117-23
references: 19710616