HIV Detection Improves When No Consent Is Required
Removing the requirement for consent prior to HIV screening may increase the number of cases of previously undiagnosed HIV identified by routine screening, according to new data presented at IDWeek 2018.
The study, authored by Aileen Tlamsa, MD, and colleagues, was presented on Friday, October 5, at IDWeek 2018 in San Francisco.
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To reach their conclusions, the researchers evaluated data of 21,413 hospitalized patients at a tertiary-care hospital in the Bronx, NY—New York state requires patient consent prior to screening for HIV but not hepatitis C (HCV)—comparing the rates of HIV and HCV screening.
The researchers estimated the number of missed HIV diagnoses attributable to the difference in screening rates by using the local prevalence of undiagnosed HIV.
Of patients who qualified for either HIV or HCV screening, 39.7% were screened for HIV and 58.6% were screened for HCV prior to discharge. Of patients who qualified for both HIV and HCV screening, 6.7% were screened for HIV alone, 29.3% were screened for HCV alone, and 30.3% were screened for both.
“The risk difference between HCV and HIV screening adjusted for patient and admission characteristics was 22.0%,” the researchers wrote. “Using an estimated prevalence of undiagnosed HIV of 0.2%, this risk difference corresponds to approximately 4 missed cases of HIV during the study period.
“There was a large difference in the number of patients appropriately screened for HIV compared [with] HCV. While the requirement for consent was the only operational difference in performing routine screening for HIV compared [with] HCV, differences in how the two viruses are perceived may also have contributed to the observed difference in screening rate,” the researchers wrote.
“Nevertheless, our findings suggest that removing the requirement for consent prior to HIV screening may increase the number of cases of previously undiagnosed HIV identified by routine screening.”
—Colleen Murphy
Reference:
Tlamsa A, Heo M, Thompson D, et al. Comparing rates of routine HIV and HCV screening to estimate the impact of consent on identifying patients with undiagnosed HIV. Poster presented at: IDWeek 2018; October 3-7, 2018; San Francisco, CA. https://idsa.confex.com/idsa/2018/webprogram/Paper72985.html. Accessed October 15, 2018.