scholarly journals 964. Opt-Out HIV- Hepatitis C (HCV) Testing at a Primary Care Resident Clinic in Columbia, SC: Who Gets Tested and Who Opts Out of Testing?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S512-S512
Author(s):  
Jodian Pinkney ◽  
Divya Ahuja ◽  
Caroline Derrick ◽  
Martin Durkin
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Demographic Variables ◽  
Demographic Characteristics ◽  
Categorical Variables ◽  
Newly Diagnosed ◽  
Opting Out ◽  
Opt Out ◽  
Primary Care Resident ◽  
Hcv Testing

Abstract Background South Carolina (SC) remains one of the most heavily affected states for both HIV and HCV infections. Males account for the majority of cases. Implementation of universal opt-out testing has improved screening rates but not much has been published describing the characteristics of those who opt out of testing. This becomes important as 10-50% of patients have opted out in previous studies. Methods Between February and August 2019, we conducted a quality improvement (QI) project which implemented opt- out HIV-HCV testing at a single primary care resident clinic in SC with the primary aim of increasing screening rates for HIV-HCV by 50%. Secondary aims included describing the demographic characteristics of the opt-out population. Persons were considered eligible for testing if they were between the ages of 18-65 years for HIV and 18-74 years for HCV. This was prior to the USPSTF 2020 guidelines which recommend HCV screening for adults aged 18-79 years. A retrospective chart review was used to obtain screening rates, opt status and demographic data. Logistic regression and the firth model were used to determine linkages between categorical variables. We present 3-month data. Results 1253 patients were seen between May 1, 2019- July 31, 2019 (See Table 1). 985 (78%) were eligible for HIV testing. 482 (49%) were tested for HIV as a result of our QI project and all tests were negative. 212 (22%) of eligible patients opted out of HIV testing. Males were 1.59 times more likely to opt out (p=0.008). (see Table 2,3) Regarding HCV, 1136 (90.7%) were deemed eligible for testing. 503 (44%) were tested for HCV as a result of our QI project. 12 (2.4%) were HCV antibody positive with viremia. 11 (90%) of antibody positive with viremia cases were in the 1945-1965 birth cohort (see Table 4). 244 (21%) opted out of HCV testing. Males and persons without a genitourinary chief complaint were more likely to opt out (p=0.02). Table 1: Demographic characteristics of the population seen at the internal medicine resident clinic between May- July 2019 Table 2: Relationship between demographic variables and the odds of being tested for HIV or HCV within the last 12 months. Logistic Model. Table 3: Relationship between demographic variables and the odds of opting out of testing for HIV or HCV. Firth Model. Conclusion Although implementation of routine HIV-HCV opt-out testing led to increased screening rates for both HIV and HCV, roughly 1 in 5 eligible patients chose to opt out of testing. Males were more likely to opt out despite accounting for the majority of newly diagnosed HCV cases. Future studies investigating drivers for opting-out in the male population could improve testing and assist with early diagnosis. Table 4: Characteristics of patients newly diagnosed with HCV positive with viremia. Disclosures All Authors: No reported disclosures

scholarly journals The Changing Demographics of Women Living with HIV/AIDS in Southern Alberta from 1982 to 2006

2012 ◽  
Vol 23 (2) ◽  
pp. e36-e40
Author(s):  
Liana Hwang ◽  
Jesse Raffa ◽  
Michael John Gill
Keyword(s):  
Hiv Testing ◽  
Hiv Infections ◽  
Hiv Care ◽  
Screening Methods ◽  
Newly Diagnosed ◽  
Female Population ◽  
Opt Out ◽  
Hiv Test ◽  
Southern Alberta ◽  
The Impact

INTRODUCTION: Women account for a growing proportion of HIV infections in Canada. This has implications with respect to prevention, diagnosis and treatment.OBJECTIVE: To describe the female population presenting for HIV care in southern Alberta and to examine the impact of opt-out pregnancy screening.METHODS: A retrospective review of demographic and clinical characteristics of all patients presenting to the Southern Alberta HIV Clinic (SAC) care program from 1982 to 2006, was performed.RESULTS: The proportion of newly diagnosed patients who were female increased from 7.5% before 1998 to 21.5% after 1998. Women were more likely to be from vulnerable populations, such as intravenous drug users (31.3% versus 13.7%, P<0.001), aboriginals/Métis (21.5% versus 8.7%, P<0.001), blacks (28.9% versus 4.9%, P<0.001) and immigrants (36.6% versus 14.7%, P<0.001). Heterosexual intercourse was the main risk factor for HIV acquisition (43.7%). Women were less likely than men to have requested HIV testing (20.9% versus 37.8%, P<0.001). Opt-out pregnancy screening accounted for 12.7% of HIV-positive tests in women, following its introduction in 1998. Of the women diagnosed by pregnancy screening, 62.1% were from HIV-endemic countries. There was an association between reason for testing and CD4 count at presentation; women who requested their HIV test had higher median CD4 counts than those diagnosed because of illness (478 cells/mL, interquartile range [IQR]=370 cells/mL versus 174 cells/mL, IQR=328 cells/mL, P<0.001) or pregnancy screening (478 cells/mL, IQR=370 cells/mL versus 271 cells/mL, IQR=256 cells/mL, P=0.001).CONCLUSIONS: Women were less likely than men to have requested HIV testing and were more likely to be diagnosed by population-based screening methods. Women, especially vulnerable groups, account for a growing number and proportion of newly diagnosed HIV infections in Alberta. The implications of expanded screening in this population merit further consideration.

Determinants of antenatal HIV testing in the opt-out approach in Nigeria: findings from the Nigerian Demographic and Health Survey

2019 ◽  
Vol 52 (4) ◽  
pp. 473-490 ◽  
Author(s):  
Ekerette Emmanuel Udoh ◽  
Boniface Ayanbekongshie Ushie
Keyword(s):  
Antenatal Care ◽  
Hiv Testing ◽  
Health Survey ◽  
Rural Women ◽  
Multivariate Regression Analysis ◽  
Lower Probability ◽  
Antenatal Visit ◽  
Opting Out ◽  
Opt Out ◽  
Nationally Representative

AbstractChildren in Nigeria are frequently born with HIV, despite available services to prevent mother-to-child transmission (MTCT). Not offering, or non-acceptance of, HIV testing during antenatal care (ANC) delays anti-retroviral commencement for infected women, thereby increasing the risk of MTCT. This study assessed the determinants of HIV testing during antenatal care in Nigeria using nationally representative data from the 2013 Nigerian Demographic Health Survey. This study included 13,352 women aged 15–49 years who reported having at least one antenatal visit. The outcome variables were HIV testing during ANC and during labour, while socio-demographic and maternal factors, including number of ANC visits, offer of HIV testing during ANC and labour, place of delivery and knowledge and counselling on MTCT, were among the independent variables. Multivariate regression analysis was used to predict HIV testing during ANC and labour. About half (53%) of the women were tested for HIV during antenatal care with 85% of those tested receiving their test results. Only 6% had HIV tests during labour. There was a 33% excess probability of urban women testing during ANC compared with rural women. Never having a previous pregnancy terminated was associated with lower odds of testing during ANC. No counselling on MTCT and no counselling to get tested were associated with a lower probability of testing during ANC. Counselling on the prevention of MTCT is crucial for women’s willingness to be tested, and acceptance of testing. More effort is needed to ensure that providers in Nigeria offer these services to all women, educate women on the dangers of opting out and ensure the earliest commencement of ARV enrolment for those infected.

Behavior intention to use routine opt-out HIV testing in primary care settings among men who have sex with men in China

AIDS Care ◽  
2019 ◽  
Vol 31 (12) ◽  
pp. 1565-1573 ◽  
Author(s):  
Lu Niu ◽  
Zixin Wang ◽  
Yuan Fang ◽  
Mary Ip ◽  
Joseph T.F. Lau
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Intention To Use ◽  
Behavior Intention ◽  
Primary Care Settings ◽  
Opt Out ◽  
Sex With Men

scholarly journals A Cross-Sectional Study Comparing Two Opt-Out HIV Testing Strategies in the Out-Patient Setting

2021 ◽  
Vol 9 ◽  
Author(s):  
Greta Tam ◽  
Samuel Yeung Shan Wong
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Care Setting ◽  
Hiv Infections ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Testing Strategies ◽  
Opt Out ◽  
Hiv Test

Background: HIV infections are generally asymptomatic, leading to undetected infections and late-stage diagnoses. There are a lack of acceptable testing strategies for routine opt-out HIV screening. Our aim was to evaluate and compare the diagnostic yield of routine opt-out HIV testing strategies in two out-patient settings in a low HIV prevalence country: The public primary care and specialist out-patient care settingMethods: A cross-sectional study was conducted in a primary care clinic over a four-week period in 2016 to 2017 and in a specialist out-patient clinic over a concurrent 11-month period. Patients were invited to complete a questionnaire assessing demographic characteristics, acceptance of opt-out HIV testing as a policy in all out-patient clinics in Hong Kong and reasons if refusing the HIV test. All respondents were offered an HIV test.Results: This study included 648 and 1,603 patients in the primary care and specialist out-patient clinic, respectively. Test acceptability was 86 and 87% in the primary care and specialist out-patient setting, respectively. Test uptake was 35 and 68% in the primary care and specialist out-patient setting, respectively. No HIV infections were detected.Conclusion: Opt-out HIV testing during routine blood taking in the specialist out-patient setting achieved a high test uptake and acceptability. In contrast, opt-out HIV testing using rapid finger-prick tests in the primary care setting was not effective.

scholarly journals 1274. Universal HIV and HCV Screening in San Diego Emergency Departments: Implications for Other Settings With a High Density of Free of Charge HIV Screening Programs

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S388-S388
Author(s):  
Martin Hoenigl ◽  
Chris Coyne ◽  
Jill Blumenthal ◽  
Gary Vilke ◽  
Susan Little
Keyword(s):  
Birth Cohort ◽  
San Diego ◽  
High Density ◽  
Hiv Screening ◽  
Newly Diagnosed ◽  
Screening Programs ◽  
Opt Out ◽  
Hiv Test ◽  
Hcv Screening ◽  
Hcv Testing

Abstract Background While HIV and HCV testing targeted to high-risk groups results in substantially higher proportions of HIV diagnoses, universal HIV and HCV screening in emergency department (ED) settings is expected to reach populations who do not perceive themselves to be at risk or are otherwise less likely to participate in HIV and HCV testing. As a consequence the CDC recommends routine HIV screening for persons 13–64 years of age, and routine HCV screening for the birth cohort (born between 1945–1965). The objective of this analysis was to evaluate the yield of universal opt-out HIV and HCV screening in the two EDs at the University of California San Diego (UCSD). Methods In July 2017, electronic medical record (EMR) based universal opt-out HIV screening (Architect HIV antibody [Ab]/HIV p24 antigen detection) for persons aged 13–64 years (excluding persons known HIV+ or reporteing an HIV test within the last 12 months) was implemented in our EDs. The EMR algorithm also identified HIV+ individuals who had been out of care for &gt;12 months. In March 2018, EMR based universal HCV screening for birth cohort was added in both EDs. Results Over a period of 9 months 7,303 HIV tests were conducted, resulting in 24 (0.3%) new HIV diagnoses, of which 21 were successfully linked to care. In five individuals without HIV infection Architect gave a false-positive result (specificity 99.93%). In addition, the EMR algorithm identified 38 out of care HIV+ individuals of which 21 were successfully relinked to care. During the 1-month HCV birth cohort screening 963 HCV Ab tests were conducted, of which 106 (11%) resulted positive. At the time being 78 of those seropositive individuals had HCV RNA testing, of which 36 (53%) resulted positive (3.7% of all participants). Conclusion In San Diego, a setting with a high density of free-of charge HIV screening programs, 1/300 HIV tests in the ED yielded a new HIV diagnosis and in total 21 newly diagnosed individuals were linked to care. Identification of HIV+ out of care individuals yielded in an equivalent number of individuals relinked to care. The rate of newly diagnosed HCV infections exceeded the rate of newly diagnosed HIV infections by &gt;10-fold outlining the importance of screening for HCV in the ED. Disclosures All authors: No reported disclosures.

scholarly journals 1273. Routine Opt-out HIV Screening and Detection of HIV Infection Among Emergency Department Patients

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S388-S388
Author(s):  
Nada Fadul ◽  
Ciarra Dortche ◽  
Richard Baltaro ◽  
Tim Reeder
Keyword(s):  
Emergency Department ◽  
Hiv Infection ◽  
Hiv Testing ◽  
Medical Center ◽  
Linkage To Care ◽  
Hiv Care ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Opt Out ◽  
Post Test

Abstract Background The Southeastern United States bears a disproportionate burden of HIV infection, accounting for nearly half of all new cases. The Centers for Disease Control and Prevention released routine opt-out testing recommendations in 2006. Our emergency department collaborated with our infectious diseases clinic (ECU-ID) to implement suggested guidelines among adults since March 2017. Methods Our primary aim was to implement routine, opt-out HIV testing in the Vidant Medical Center Emergency Department (ED) for patients between 18 and 65 years of age who have blood work completed, and have not had a test documented in the electronic medical record (EMR) in the last year. A secondary aim was to successfully link HIV-positive patients to care at ECU-ID or preferred clinic. Methods defining programmatic success included developing nurse directed opt-out ordering protocol, integrating testing into normal ED workflow, utilizing the existing EMR to prompt testing, and hiring a linkage coordinator to initiate post-test counseling and linkage-to-care. Results Since March 2, 2017, a total of 7,109 HIV tests were performed; an average of 592 monthly tests conducted compared with a previous average of 10 stat tests. Testing increased 5,820% compared with 2015. Of the 21 HIV-positive patients found, 16 were newly diagnosed. Among those newly diagnosed, 14 (87.5%) were linked to care; and among the five known positives, two (40%) were linked to care. Reasons why patients could not be linked included incarceration, refusal to link to care, and re-location. Conclusion Joined with the implementation of a routinized ED HIV testing program, a seamless process was developed to link persons found to be positive in the ED to HIV care services; therefore, establishing a systems-level prevention model. Future plans include expanding testing to adolescents and utilizing similar methods to integrate Hepatitis C testing. Disclosures All Authors. Gilead Sciences, Inc.: Grant Investigator, Grant recipient and Salary.

scholarly journals Pediatric Primary Care Providers' Attitudes Towards Routine, Opt-Out HIV Testing

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Noemi Spinazzi ◽  
Ann Petru ◽  
Teresa Courville ◽  
Tricia Smallwood
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Primary Care Providers ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Opt Out

scholarly journals Opt-out provider-initiated HIV testing and counselling in primary care outpatient clinics in Zambia

2011 ◽  
Vol 89 (5) ◽  
pp. 328-335A ◽  
Author(s):  
Stephanie M Topp ◽  
Julien M Chipukuma ◽  
Matimba M Chiko ◽  
Chibesa S Wamulume ◽  
Carolyn Bolton-Moore ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Outpatient Clinics ◽  
Opt Out ◽  
Hiv Testing And Counselling

scholarly journals Demographic Characteristics and Buyers Purchase Decision of Two Wheeler Brands in Bagmati Province, Nepal

The Batuk ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 1-14
Author(s):  
Makshindra Thapa
Keyword(s):  
Demographic Variables ◽  
Demographic Characteristics ◽  
Survey Study ◽  
Categorical Variables ◽  
Purchase Decision ◽  
Purchase Decisions ◽  
Purchasing Decisions ◽  
Chi Square ◽  
Chi Square Analysis ◽  
Two Wheeler

The purpose of this paper is to analyze buyers’ demographic characteristics that influence purchasing decisions of two wheelers brands available in the Nepalese market. The survey study was conducted in the four districts of Bagmati province. Altogether, opinions of 208 respondents were included in the study to express their assertion of two wheeler purchasing decisions. Cross tabulation was done to identify patterns of demographic (categorical) variables and two wheeler brands. The chi-square analysis was done to examine associations between demographic variables and purchase decisions of two wheeler brands.  The results of chi-square analysis indicated that buyers’ gender, age, education and occupation have highly significant association with purchase decision. Similarly, income level and marital status are significantly associated with purchase decision. The various categories of demographic characteristics analyzed in the study influence buyer two wheeler brand purchase decisions.

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