Routine HIV Testing Within the ED of a Major Trauma Centre
Routine HIV Testing Within the ED of a Major Trauma Centre
Within a large trauma centre ED, it was possible to achieve an uptake of 30% in an HIV opt-out testing pilot study. In this short time, eight new HIV diagnoses were made. One-quarter of newly diagnosed patients were diagnosed during seroconversion, further indicating the importance of testing in the ED to reduce onward transmission. Patients diagnosed had mainly late diagnoses and all were from high-risk groups, suggesting further scope for truly universal HIV testing. Loss to follow-up is a significant problem in the UK and this pilot study enabled re-linkage to care for those patients. Although few completed the staff survey, 95% of those who completed it supported permanent routine HIV testing within the ED. The pilot study has raised awareness about HIV infection and its clinical indicators within the department and enabled us to obtain interim funding through the CCG to continue as well as justifying the ongoing negotiations to make this routine.
Conclusions
Within a large trauma centre ED, it was possible to achieve an uptake of 30% in an HIV opt-out testing pilot study. In this short time, eight new HIV diagnoses were made. One-quarter of newly diagnosed patients were diagnosed during seroconversion, further indicating the importance of testing in the ED to reduce onward transmission. Patients diagnosed had mainly late diagnoses and all were from high-risk groups, suggesting further scope for truly universal HIV testing. Loss to follow-up is a significant problem in the UK and this pilot study enabled re-linkage to care for those patients. Although few completed the staff survey, 95% of those who completed it supported permanent routine HIV testing within the ED. The pilot study has raised awareness about HIV infection and its clinical indicators within the department and enabled us to obtain interim funding through the CCG to continue as well as justifying the ongoing negotiations to make this routine.