title: Prevalence of HIV infection and acceptability of point-of-care testing in a Canadian inner-city emergency department.
abstract: OBJECTIVE
  The objective of this study was to estimate the seroprevalence of HIV infection and the acceptability of point-of-care HIV testing in an innercity Canadian emergency department.
  
  
  METHODS
  We conducted a prospective cohort study in an urban tertiary care emergency department between August 2009 and January 2011. Randomly selected patients were enrolled using probabilistic sampling based on patient volumes. Inclusion criteria were age 19-75 years and ability to provide informed consent. Patients who were intoxicated or in extremis were excluded. After informed consent and brief pre-test counselling, participants' HIV status was obtained using the INSTI HIV-1/HIV-2 Antibody Test. Participants completed a questionnaire on HIV risk behaviours and satisfaction with emergency department HIV testing. Participants with a positive result or those having other blood tests received confirmatory Western blot testing. HIV-positive participants were offered immediate referral to an HIV specialty clinic.
  
  
  RESULTS
  A total of 2,077 patients were approached, and 1,402 (67.5%) agreed to participate. Participants' mean age was 43.3 years, and 58.4% of participants were male. The HIV antibody seroprevalence based on the point-of-care test was 65/1,402 (4.6%; 95% confidence interval: 3.5%-5.8%). No new diagnoses of HIV were identified in our cohort. Patient satisfaction with point-of-care HIV testing was high (mean satisfaction score 9.6/10).
  
  
  CONCLUSIONS
  On the basis of a rapid, point-of-care HIV antibody test, the seroprevalence rate of HIV in an inner city emergency department was 4.6%. Point-of-care testing in the emergency department is acceptable, and patients' satisfaction with the testing procedure was high.
authors.affiliation: Department of Emergency Medicine, University of British Columbia; Providence Health Care; School of Population and Public Health, University of British Columbia; Centre for Health Evaluation and Outcome Sciences (CHÉOS), Vancouver, BC. robstenstrom@shaw.ca.
authors.forename: Rob
authors.initials: R
authors.lastname: Stenstrom
authors.forename: Daphne
authors.initials: D
authors.lastname: Ling
authors.forename: Eric
authors.initials: E
authors.lastname: Grafstein
authors.forename: Rolando
authors.initials: R
authors.lastname: Barrios
authors.forename: Chris
authors.initials: C
authors.lastname: Sherlock
authors.forename: Reka
authors.initials: R
authors.lastname: Gustafson
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Osati
authors.forename: Iraj
authors.initials: I
authors.lastname: Poureslami
authors.forename: Aslam
authors.initials: A
authors.lastname: Anis
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D002170:Canada / Q000453:epidemiology; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D015528:HIV Seroprevalence; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D000067716:Point-of-Care Testing / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies
chemical_list: D000914:Antibodies, Viral