title: Analysis of HIV testing acceptance and risk factors of an adolescent cohort using emergency department-based multimedia HIV testing and counseling.
abstract: BACKGROUND
  The social environment in the Bronx, NY, has led to HIV infection rates among young people that are much higher than the national average.
  
  
  METHODS
  A prospective observational study on a convenience sample of medically stable emergency department (ED) patients was conducted from October 1, 2005, to August 31, 2012. Acceptability of the tested model was determined by assessing the number of patients tested and identified HIV infections. Data were compared with data from the rest of the ED that tested for HIV.
  
  
  RESULTS
  A total of 10,149 adolescents were approached during this period, of which 9.5% refused or were ineligible to test. Of those approached, 38.9% of patients were male, 59.7% were Hispanic, and 33.6% were black. The mean age was 19.4 ± 1.4 years, and 8.2% of patients were men who have sex with men. For risk behavior profiles, 24.3% never used condoms in the past 3 months. Incidence of HIV was less than 1%, and 92.6% of HIV-positive patients were linked to care. Of the patients who completed a postsatisfaction survey, 82.4% felt influenced to change their sexual practices. A smaller percentage of adolescent had tested previously for HIV compared with nonadolescents (67.7% vs. 80.6%). There was a slightly larger percentage of adolescents that accepted HIV testing compared with nonadolescents (95.4% vs. 90.8%). Adolescents who were positive for HIV were tested earlier in the progression of the disease, with higher median CD4 cell counts and lower viral loads compared with nonadolescents.
  
  
  CONCLUSIONS
  Adolescents were highly receptive to a multimedia-integrated ED-based HIV testing program, as indicated by their high uptake of testing.
authors.affiliation: Jacobi Medical Center, Bronx, NY 10461, USA. yvette.calderon@nbhn.net
authors.forename: Yvette
authors.initials: Y
authors.lastname: Calderon
authors.forename: Katherine
authors.initials: K
authors.lastname: Chou
authors.forename: Ethan
authors.initials: E
authors.lastname: Cowan
authors.forename: John Y
authors.initials: JY
authors.lastname: Rhee
authors.forename: Sheba
authors.initials: S
authors.lastname: Mathew
authors.forename: Reena
authors.initials: R
authors.lastname: Ghosh
authors.forename: Jade
authors.initials: J
authors.lastname: Fettig
authors.forename: Jillian
authors.initials: J
authors.lastname: Nickerson
authors.forename: Jason
authors.initials: J
authors.lastname: Leider
mesh_terms: D000293:Adolescent; D003376:Counseling; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D019212:Multimedia; D009518:New York / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012944:Social Support; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult