title: Factors associated with patients who prefer HIV self-testing over health professional testing in an emergency department-based rapid HIV screening program.
abstract: Kiosk-facilitated HIV self-testing has been shown to be accurate and well accepted by emergency department (ED) patients. We investigated factors associated with patients who preferred self-testing over testing performed by health professionals in an ED-based HIV screening program. This opt-in program evaluation studied 332 patients in an inner-city academic ED from February 2012 to April 2012, when a kiosk-based HIV self-testing program was standard of care. The first kiosk in the 2-stage system registered patients and assessed their interest in screening, while the second kiosk gathered demographic and risk factor information and also provided self-testing instructions. Patients who declined to self-test were offered testing by staff. Broad eligibility included patients aged 18-64 years who were not critically ill, English-speaking, able to provide informed consent, and registered during HIV program operational hours. Data were analyzed using descriptive statistical analysis and Chi squared tests; 160 (48.2%) of 332 patients consenting to testing chose to use a kiosk to guide them performing self-testing. Patients aged 25-29 years and those whose primary ED diagnosis was not infectious disease-related were more likely to prefer HIV self-testing (OR = 2.19, 95% CI: 1.17-4.10; OR = 1.79, 95% CI: 1.03-3.12). HIV self-testing in the ED could serve as a complementary testing approach to the conventional modality.
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Hsieh
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Kaylin J
authors.initials: KJ
authors.lastname: Beck
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.|2 Division of Infectious Diseases, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Rothman
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Gauvey-Kern
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Alonzo
authors.initials: A
authors.lastname: Woodfield
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Peterson
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Signer
authors.affiliation: 1 Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.|2 Division of Infectious Diseases, School of Medicine, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D000293:Adolescent; D000328:Adult; D015142:Baltimore; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D013997:Time Factors
keywords: Emergency department; HIV; screening; self-testing