title: Expanded HIV testing in the US Department of Veterans Affairs, 2009-2011.
abstract: OBJECTIVE
  We measured HIV testing and seropositivity among veterans in Veterans Affairs (VA) care for calendar years 2009 through 2011 and analyzed 2011 results by patient demographics.
  
  
  METHODS
  We performed a repeated-measures cross-sectional study using standardized electronic data extraction from the VA electronic health records for all veterans with at least 1 outpatient visit during 2009 through 2011. We analyzed testing rates and seropositivity by demographic characteristics for 2011.
  
  
  RESULTS
  Of veterans with an outpatient visit, 20.0% had an HIV test in 2011, compared with 9.2% in 2009. Documented HIV testing rates were highest in women and Blacks. Of confirmed positive test results, 67.0% were in outpatients older than 50 years. Seropositivity was highest among men aged 30 to 49 years, women aged 50 to 69 years, and Black outpatients of both genders. Implementation of an electronic clinical reminder was associated with higher testing rates.
  
  
  CONCLUSIONS
  The significant effect of an electronic clinical reminder suggests that such decision support tools can substantially increase testing rates. The frequency of positive test results in older individuals suggests the need for additional work to define optimum approaches to HIV testing in this population.
authors.affiliation: All authors are with the Department of Veterans Affairs, Office of Public Health, Washington, DC.
authors.forename: Maggie
authors.initials: M
authors.lastname: Czarnogorski
authors.forename: James
authors.initials: J
authors.lastname: Halloran Cns
authors.forename: Caitlin
authors.initials: C
authors.lastname: Pedati
authors.forename: Erin K
authors.initials: EK
authors.lastname: Dursa
authors.forename: Janet
authors.initials: J
authors.lastname: Durfee
authors.forename: Richard
authors.initials: R
authors.lastname: Martinello
authors.forename: Victoria
authors.initials: V
authors.lastname: Davey
authors.forename: David
authors.initials: D
authors.lastname: Ross
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006679:HIV Seropositivity / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010045:Outpatients; D044469:Racial Groups; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs