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Improving HIV Screening with Rapid Testing and Streamlined Counseling

Improving HIV Screening with Rapid Testing and Streamlined Counseling. Henry D. Anaya, PhD Steven M. Asch, MD MPH, Tuyen Hoang, PhD, Joya F. Golden, BA, Matthew B. Goetz, MD, Allen Gifford, MD, Candice Bowman, PhD RN. Most people worldwide unaware of their HIV status.

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Improving HIV Screening with Rapid Testing and Streamlined Counseling

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  1. Improving HIV Screening with Rapid Testing and Streamlined Counseling Henry D. Anaya, PhD Steven M. Asch, MD MPH, Tuyen Hoang, PhD, Joya F. Golden, BA, Matthew B. Goetz, MD, Allen Gifford, MD, Candice Bowman, PhD RN

  2. Most people worldwide unaware of their HIV status • 45 million infected with HIV worldwide • 95% unaware of HIV-positive status • Those aware of HIV status lower HIV-risk behaviors • Even those in care don’t get HIV tested

  3. Barrier Counseling takes time MDs don’t prioritize prevention Patients don’t return for results Intervention Streamlined counseling Nurse-based screening HIV rapid testing Why don’t people in care get HIV testing?

  4. HIV Rapid Testing

  5. Study design Patients randomized to one of three models: • Usual Care (UC) • Nurse-based screening (NBS) • Nurse-based screening + rapid testing/streamlined counseling (NBS+RT/SC)

  6. Endpoints HIV Test order Receipt of HIV test results Patient knowledge Cost-effectiveness Covariates Demographics HIV risk factors Comorbid conditions (TB, STDs, HEP B/C) Study design (cont’d)

  7. Enrollment and Randomization Agreed to participate 283 Enrolled189Excluded 94 Usual Care Nurse Screening Nurse Screening + Rapid Test 62 64 63 Not between 18-65 yrs HIV test within past year Not competent to consent

  8. Characteristics of patient population

  9. Results: HIV test ordered? *p=<.001

  10. HIV Results received? *p=<.003 **p=<.001

  11. Conclusions • HIV Test order • Nurse Screening increased test order compared to Usual Care; • Slight increase w/ addition ofRapid Test/Streamlined Counseling • Receipt of HIV results • Nurse Screening increased receipt of results compared to Usual Care; • Significant increase w/ addition of Rapid Test/Streamlined Counseling

  12. Implications • Expansion into nationwide VA delivery system • Basis for other outreach efforts • Integration into similar healthcare systems

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