title: Addressing unmet need for HIV testing in emergency care settings: a role for computer-facilitated rapid HIV testing?
abstract: HIV testing in emergency departments (EDs) remains underutilized. The authors evaluated a computer tool to facilitate rapid HIV testing in an urban ED. Randomly assigned nonacute adult ED patients were randomly assigned to a computer tool (CARE) and rapid HIV testing before a standard visit (n = 258) or to a standard visit (n = 259) with chart access. The authors assessed intervention acceptability and compared noted HIV risks. Participants were 56% nonWhite and 58% male; median age was 37 years. In the CARE arm, nearly all (251/258) of the patients completed the session and received HIV results; four declined to consent to the test. HIV risks were reported by 54% of users; one participant was confirmed HIV-positive, and two were confirmed false-positive (seroprevalence 0.4%, 95% CI [0.01, 2.2]). Half (55%) of the patients preferred computerized rather than face-to-face counseling for future HIV testing. In the standard arm, one HIV test and two referrals for testing occurred. Computer-facilitated HIV testing appears acceptable to ED patients. Future research should assess cost-effectiveness compared with staff-delivered approaches.
authors.affiliation: New York University College of Nursing, New York, NY, USA. akurth@nyu.edu
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.forename: Anneleen
authors.initials: A
authors.lastname: Severynen
authors.forename: Freya
authors.initials: F
authors.lastname: Spielberg
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D003430:Cross-Sectional Studies; D003936:Diagnosis, Computer-Assisted; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors; D055815:Young Adult