title: Routine HIV Screening in an Urban Community Health Center: Results from a Geographically Focused Implementation Science Program.
abstract: OBJECTIVE
  CDC has recommended routine HIV screening since 2006. However, few community health centers (CHCs) routinely offer HIV screening. Research is needed to understand how to implement routine HIV screening programs, particularly in medically underserved neighborhoods with high rates of HIV infection. A routine HIV screening program was implemented and evaluated in a Philadelphia, Pennsylvania, neighborhood with high rates of HIV infection.
  
  
  METHODS
  Implementation science is the study of methods to promote the integration of research findings and evidence into health-care policy and practice. Using an implementation science approach, the results of the program were evaluated by measuring acceptability, adoption, and penetration of routine HIV screening.
  
  
  RESULTS
  A total of 5,878 individuals were screened during the program. HIV screening was highly accepted among clinic patients. In an initial needs assessment of 516 patients, 362 (70.2%) patients reported that they would accept testing if offered. Routine screening policies were adopted clinic-wide. Staff trainings, new electronic medical records that prompted staff members to offer screening and evaluate screening rates, and other continuing quality-improvement policies helped promote screenings. HIV screening offer rates improved from an estimated 5.0% of eligible patients at baseline in March 2012 to an estimated 59.3% of eligible patients in December 2014. However, only 5,878 of 13,827 (42.5%) patients who were offered screening accepted it, culminating in a 25.2% overall screening rate. Seventeen of the 5,878 patients tested positive, for a seropositivity rate of 0.3%.
  
  
  CONCLUSIONS
  Routine HIV screening at CHCs in neighborhoods with high rates of HIV infection is feasible. Routine screening is an important tool to improve HIV care continuum outcomes and to address racial and geographic disparities in HIV infection.
authors: Rhode Island Public Health Institute, Providence, RI; Brown University, School of Public Health, Providence, RI.
authors: Amy
authors: A
authors: Nunn
authors: Rhode Island Public Health Institute, Providence, RI.
authors: Caitlin
authors: C
authors: Towey
authors: Brown University, School of Public Health, Providence, RI.
authors: Philip A
authors: PA
authors: Chan
authors: North Carolina A&T State University, Greensboro, NC.
authors: Sharon
authors: S
authors: Parker
authors: Family Practice & Counseling Network, Philadelphia, PA.
authors: Emily
authors: E
authors: Nichols
authors: Family Practice & Counseling Network, Philadelphia, PA.
authors: Patrick
authors: P
authors: Oleskey
authors: Rhode Island Public Health Institute, Providence, RI.
authors: Annajane
authors: A
authors: Yolken
authors: Rhode Island Public Health Institute, Providence, RI.
authors: Julia
authors: J
authors: Harvey
authors: Brown University, School of Public Health, Department of Epidemiology, Providence, RI.
authors: Geetanjoli
authors: G
authors: Banerjee
authors: Tufts University, School of Medicine, Boston, MA.
authors: Thomas
authors: T
authors: Stopka
authors: Drexel University, College of Medicine, Division of Infectious Diseases and HIV Medicine, Philadelphia, PA.
authors: Stacey
authors: S
authors: Trooskin
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods; D000293:Adolescent; D000328:Adult; D000368:Aged; D003151:Community Health Centers / Q000458:organization & administration; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000458:organization & administration; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D016730:Program Development; D019037:Urban Health Services / Q000458:organization & administration; D055815:Young Adult