The impact of experience with AIDS on HIV testing and counseling practices: a study of U.S. infectious disease teaching hospitals and Minnesota hospitals.

A survey on HIV antibody testing practices was sent to the 200 hospitals in the United States that conduct infectious disease (ID) fellowship training and to all 171 short-term care Minnesota hospitals. Responses were obtained from 124 U.S. ID hospitals (62%) and from 133 (78%) Minnesota hospitals. The U.S. ID hospitals estimated that consent for HIV antibody testing is obtained 70.1% of the time, that consent is both obtained and documented 54.3% of the time, and that risk-reduction counseling in conjunction with such testing is provided 51.4% of the time. The Minnesota hospitals estimated that consent for HIV antibody testing is obtained 35.2% of the time, that consent is both obtained and documented 25.7% of the time, and that risk-reduction counseling in conjunction with such testing is provided 21.8% of the time. Wide variance was noted in both the U.S. and Minnesota responses. Those U.S. hospitals serving higher numbers of persons with AIDS gave higher estimates for each of the 3 items (p less than .05); similar findings were noted among the Minnesota hospitals. The data suggests that standard clinical use of HIV testing remains deficient.