Waxman Michael Jay, Kimaiyo Sylvester, Ongaro Neford, Wools-Kaloustian Kara K, Flanigan Timothy P, Carter E Jane
Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Brown Medical School, Providence, Rhode Island 02903, USA.
AIDS Patient Care STDS. 2007 Dec;21(12):981-6. doi: 10.1089/apc.2007.0075.
This paper reports the initial operational outcomes of an emergency department-based HIV testing program in a high-prevalence and resource-limited setting by describing (1) the number and percentage of patients approached, tested, and found to be HIV positive and (2) the linkage of care to the HIV clinic. A retrospective log and chart review of the initial 5 months (January 2006 to April 2006) of the HIV testing program was performed. Patients were selected for HIV testing by routine screening and by provider initiated referrals. Out of the 1371 patients who were approached for HIV testing, 1339 (97.7%) patients were tested for HIV. Three hundred twelve (22.7%) of the patients tested were HIV positive. Within a sample group of patients newly diagnosed with HIV in the department, 82% were compliant with their initial HIV clinic visit and 65% were compliant with a 1-month follow-up visit. The implementation of an emergency department-based HIV testing program in a high HIV prevalence and resource poor country is feasible with a high percentage of patients accepting HIV testing and a high percentage of positive patients presenting to follow-up care. Establishment of rapid HIV testing in emergency departments can identify significant numbers of HIV-positive patients who would otherwise remain undiagnosed and provides an education opportunity for those patients who are HIV negative.
本文通过描述（1）接受检测、实际进行检测并被发现为HIV阳性的患者数量及百分比，以及（2）与HIV诊所的护理联系，报告了在高流行率和资源有限环境下基于急诊科的HIV检测项目的初步运作结果。对HIV检测项目最初5个月（2006年1月至2006年4月）的日志和图表进行了回顾性审查。通过常规筛查和医生发起的转诊来选择进行HIV检测的患者。在1371名被邀请进行HIV检测的患者中，1339名（97.7%）患者接受了HIV检测。接受检测的患者中有312名（22.7%）HIV呈阳性。在该科室新诊断为HIV的患者样本组中，82%的患者按要求进行了首次HIV诊所就诊，65%的患者进行了1个月的随访就诊。在HIV高流行率和资源匮乏的国家实施基于急诊科的HIV检测项目是可行的，接受HIV检测的患者比例很高，呈阳性的患者接受后续护理的比例也很高。在急诊科开展快速HIV检测能够识别大量原本会仍未被诊断的HIV阳性患者，并为HIV阴性的患者提供了一个教育机会。
