title: Evaluating the 2010 New York State HIV testing law in NYC ambulatory practices using electronic health records.
abstract: BACKGROUND
  In 2010, the New York State Legislature made it mandatory to offer an HIV test to people aged 13-64 years receiving hospital or primary care services, with limited exceptions. In this study, we used data from New York City practices to evaluate the impact of the law on HIV testing rates in ambulatory care.
  
  
  METHODS
  We collected quarterly testing data from the electronic health records of 218 practices. We calculated overall and stratified crude testing rates. Using univariate and multivariate generalized estimating equation models, we assessed the odds of testing in the year before the law (baseline) versus the first and second year after the law's implementation (year 1 and year 2).
  
  
  RESULTS
  During baseline, the odds of testing did not increase significantly. During year 1, the odds of testing significantly increased by 50% in the univariate model and 200% after adjusting for confounders. During year 2, the odds of testing increased 10%. This was only significant in the univariate model. The crude quarterly testing rate increased from 2.8% to 5.7% from baseline to year 2.
  
  
  CONCLUSIONS
  Our evaluation showed that after the implementation of the HIV testing law, there was an increase in HIV testing among NYC ambulatory practices. Testing rates remained modest, but considerable improvement was seen in community health centers, in age ranges targeted by the law and in practices that were screening for HIV at baseline. This study suggests that legislation may be effective when used in a comprehensive prevention strategy.
authors.affiliation: *Primary Care Information Project; and †Bureau of HIV/AIDS Prevention and Control, New York City Department of Health and Mental Hygiene, Queens, NY.
authors.forename: Remle
authors.initials: R
authors.lastname: Newton-Dame
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Wang
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Kim
authors.forename: Zoe R
authors.initials: ZR
authors.lastname: Edelstein
authors.forename: Blayne
authors.initials: B
authors.lastname: Cutler
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Tsoi
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data* / Q000639:trends; D000553:Ambulatory Care; D057286:Electronic Health Records; D006801:Humans; D007603:Jurisprudence; D009518:New York; D009519:New York City