Trends in Human Immunodeficiency Virus (HIV) Infection Among a Patient Population of an Inner-City Emergency Department: Implications for Emergency Department—Based Screening Programs for HIV Infection

Personnel of inner-city emergency departments (EDs), which are frequently the only source of medical care for many patients, may be in a unique position to detect human immunodeficiency virus (HIV) infection earlier than personnel at other recommended screening sites. To assist development of ED-bas...

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Bibliographic Details
Published in:Clinical infectious diseases 1995-10, Vol.21 (4), p.867-875
Main Authors: Kelen, Gabor D., Hexter, David A., Hansen, Karen N., Tang, Nelson, Pretorius, Scott, Quinn, Thomas C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
AIDS
AIDS/HIV
Biological and medical sciences
Black people
CD4 Lymphocyte Count
Clinical Articles
Counseling
Emergency departments
Emergency Medical Services - statistics & numerical data
Female
HIV
HIV infections
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV Seropositivity
HIV Seroprevalence
Hospital admissions
human immunodeficiency virus
Humans
Immunodeficiencies
Immunodeficiencies. Immunoglobulinopathies
Immunopathology
Infections
Lymphocytes
Male
Mass Screening
Medical sciences
Middle Aged
Predisposing factors
Seroepidemiologic studies
Urban Population
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Summary:Personnel of inner-city emergency departments (EDs), which are frequently the only source of medical care for many patients, may be in a unique position to detect human immunodeficiency virus (HIV) infection earlier than personnel at other recommended screening sites. To assist development of ED-based screening strategies for HIV infection, we undertook a serosurvey of HIV infection in adult patients attending an ED during a 6-week period in 1992 using an identity-unlinked technique and compared our findings with data collected similarly in 1988. Of 1,606 patients, 183 (11.4%) were HIV-positive, compared with 6.0% in 1988. Seroprevalence rates of HIV infection among patients only at risk of heterosexual transmission increased more than fourfold (7% to 30.3%). CD4+ cell counts were higher in those patients with undiagnosed HIV infection than in those with known HIV infection. Targeting minority patients aged 25–44 years, intravenous drug users, and those patients at heterosexual risk would have identified 87% of patients with new HIV infection, while requiring screening of 41% of the study sample. Targeted voluntary screening programs in certain EDs would likely detect significant numbers of new early HIV infections.
ISSN:1058-4838
1537-6591
DOI:10.1093/clinids/21.4.867