Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-20T07:40:11.589Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of a Hospital Admission HIV Antibody Voluntary Screening Program

Published online by Cambridge University Press:  21 June 2016

Richard L. Harris ,
Eugene V. Boisaubin ,
Pamela D. Salyer  and
Denise F. Semands
Richard L. Harris*
Affiliation:
The Methodist Hospital, Department of Medicine, Sections of Infectious Disease, Houston, Texas Baylor College of Medicine, Houston, Texas
Eugene V. Boisaubin
Affiliation:
General Internal Medicine, Houston, Texas Baylor College of Medicine, Houston, Texas
Pamela D. Salyer
Affiliation:
Information Services, Houston, Texas
Denise F. Semands
Affiliation:
Patient Services, Houston, Texas
*
The Methodist Hospital, MS910, 6565 Fannin Street, Houston, TX 77030
Get access Rights & Permissions [Opens in a new window]

Abstract

Voluntary screening for the presence of human immunodeficiency virus (HIV) is recommended by the healthcare profession. The optimal settings to accomplish screening have not been established. We evaluated an admission HIV screening program in a large private hospital to assess advantages and disadvantages in this setting. In a three-month study period, 4,535 of 8,868 patients (51%) admitted to the hospital agreed to HIV testing. Serum specimens from 500 patients who refused testing were blindly, anonymously tested. The seroprevalence of the patients agreeing to (0.26%) and refusing (0.60%) testing was not statistically different (p = .12). There were 12 HIV cases discovered; ten (83%) of these were known to be in a high-risk group at the time of admission. Eighty-five percent of patients interviewed were in favor of this screening program. Difficulties associated with confidentiality or consent were not evident. Calculated charges of testing for each HIV case discovery was $14,550. There was no evidence that this screening program provided for a more effective infection control policy to prevent nosocomial HIV transmission. A hospital admission HIV screening program can be implemented can meet with favorable patient opinion and can detect previously unknown HIV-positive patients. Hospitals are an efficient and practical setting for HIV testing. The benefit of this program appears to be greater for the patient than hospital or healthcare worker. Cost-benefit analyses will identify optimal candidates to be screened in different hospital populations.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 11 , Issue 12 , December 1990 , pp. 628 - 634
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Rhame, FS, Maki, DG. The case for wider use of testing for HIV infection. N Engl J Med. 1989;320:1248–1253.CrossRefGoogle ScholarPubMed
2. Lo, B, Steinbrook, RL. Cooke, M, Coates, TJ, Walters, EJ, Hully, SB. Voluntary screening for human immunodeficiency virus (HIV) infection: weighing the benefits and harms. Ann Intern Med. 1989:110:727–733.Google ScholarPubMed
3. Hagen, MD, Meyer, KB, Pauker, SG. Routine preoperative screening for HIV: does the risk to the surgeon outwiegh the risk to the patient? JAMA. 1988;259:1357–1361.CrossRefGoogle Scholar
4. Weiss, R, Thier, SO. HIV testing is the answer what's the question? N Engl J Med. 1988;319:1010–1012.CrossRefGoogle ScholarPubMed
5. Sherer, R. Physician use of the HIV antibody test: the need for consent, counseling, confidentiality and caution. JAMA. 1988;259:264–265.CrossRefGoogle Scholar
6. Volberding, PA. Lagakos, SW, Koch, MA, et al. Zidovudine in asymptomatic human immunodeficiency virus infection: a controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. N Engl J Med. 1990;322:941–949.CrossRefGoogle ScholarPubMed
7. CDC. Estimates of HIV prevalence and projected AIDS cases: summary of a workshop, October 31-November 1, 1989. MMWR. 1990;39:110–112, 117–119.Google Scholar
8. Blendon, RJ, Donelan, K. Discrimination against people with AIDS: the public's perspective. N Engl J Med. 1988:319:1022–1026.CrossRefGoogle ScholarPubMed
9. Boisaubin, EV, Dresser, R. Informed consent in emergency care: illusion and reform. Ann Emerg Med. 1987:16:62–67.CrossRefGoogle ScholarPubMed
10. Castro, KG, Lifson, AR, White, CR, et al. Investigations of AIDS patients with no previously identified risk factors. JAMA. 1988;259:1338–1342.CrossRefGoogle ScholarPubMed
11. Quarterly report to the domestic policy council on the prevalence and rate of spread of HIV and AIDS-United States. MMWR. 1988;37:551–554, 559.Google Scholar
12. Lindsay, MK, Peterson, HB, Feng, TI, Slade, BA, Willis, S, Klein, L. Routine antepartum human immunodeficiency virus infection screening in an inner-city population. Obstet Gynecol. 1989;74:289–294.Google Scholar
13. Gordin, FM, Gilbert, C, Hawley, HP, Willoughby, A. Prevalence of human immunodeficiency virus and hepatitis B virus in unselected hospital admissions: implications for mandatory testing and universal precautions. J Infect Dis. 1990;161:14–17.CrossRefGoogle ScholarPubMed
14. Kelen, GD, Fritz, S, Qaqish, B, et al. Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med. 1988;318:1645–1650.CrossRefGoogle ScholarPubMed
15. Soderstrom, CA, Furth, PA, Glasser, D, Dunning, RW, Groseclose, SL, Cowley, RA. HIV infection rates in a trauma center treating predominantly rural blunt trauma victims. J Trauma. 1989;29:1526–1530.CrossRefGoogle Scholar
16. Hoff, R, Berardi, VP, Weiblen, BJ, Mahoney-Trout, L, Mitchell, ML, Grady GE Seroprevalence of human immunodeticiency virus among childbearing women: estimation by testing samples of blood from newborns. N Engl J Med. 1988;318:525–530.CrossRefGoogle Scholar
17. Landesman, S, Minkoff, H, Holman, S. McCalla, S, Sijin, O. Serosurvey of human immunodeficiency virus infection in parturients: implication for human immunodeticiency virus test in programs of pregnant women . JAMA. 1987;258: 2701–2703.CrossRefGoogle Scholar
18. Hull, HF, Bettinger, CJ, Gallaher, MM, Keller, NM, Wilson, J, Mertz, GJ. Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic. JAMA. 1988;260:935–938.CrossRefGoogle Scholar
19. Handsfield, HH, Cummings, MJ, Swenson, PD. Prevalence of antibody to human immunodeficiency virus and hepatitis B surface antigen in blood samples submitted to a hospital laboratory: implications for handling specimens. JAMA. 1987;258:3395–3397.CrossRefGoogle ScholarPubMed
20. Becker, CE, Cone, JE, Gerberding, J. Occupational infection with human immunodeficiency virus (HIV): risks and risk reduction. Ann Intern Med. 1989:110:653–656.CrossRefGoogle ScholarPubMed
21. Carey, JS. Routine preoperative screening for HIV. JAMA. 1988;260:179.CrossRefGoogle Scholar
22. Eickhoff, TC. Hospital policies on HIV antibody testing. JAMA. 1988;259:1861–1862.CrossRefGoogle ScholarPubMed