Stenstrom Rob, Ling Daphne, Grafstein Eric, Barrios Rolando, Sherlock Chris, Gustafson Reka, Osati Farzaneh, Poureslami Iraj, Anis Aslam
Department of Emergency Medicine, University of British Columbia; Providence Health Care; School of Population and Public Health, University of British Columbia; Centre for Health Evaluation and Outcome Sciences (CHÉOS), Vancouver, BC.
Can J Public Health. 2016 Oct 20;107(3):e291-e295. doi: 10.17269/cjph.107.5318.
The objective of this study was to estimate the seroprevalence of HIV infection and the acceptability of point-of-care HIV testing in an innercity Canadian emergency department.
We conducted a prospective cohort study in an urban tertiary care emergency department between August 2009 and January 2011. Randomly selected patients were enrolled using probabilistic sampling based on patient volumes. Inclusion criteria were age 19-75 years and ability to provide informed consent. Patients who were intoxicated or in extremis were excluded. After informed consent and brief pre-test counselling, participants' HIV status was obtained using the INSTI HIV-1/HIV-2 Antibody Test. Participants completed a questionnaire on HIV risk behaviours and satisfaction with emergency department HIV testing. Participants with a positive result or those having other blood tests received confirmatory Western blot testing. HIV-positive participants were offered immediate referral to an HIV specialty clinic.
A total of 2,077 patients were approached, and 1,402 (67.5%) agreed to participate. Participants' mean age was 43.3 years, and 58.4% of participants were male. The HIV antibody seroprevalence based on the point-of-care test was 65/1,402 (4.6%; 95% confidence interval: 3.5%-5.8%). No new diagnoses of HIV were identified in our cohort. Patient satisfaction with point-of-care HIV testing was high (mean satisfaction score 9.6/10).
On the basis of a rapid, point-of-care HIV antibody test, the seroprevalence rate of HIV in an inner city emergency department was 4.6%. Point-of-care testing in the emergency department is acceptable, and patients' satisfaction with the testing procedure was high.
本研究的目的是评估加拿大一个市中心急诊科中HIV感染的血清流行率以及即时检测HIV的可接受性。
2009年8月至2011年1月期间，我们在一家城市三级护理急诊科进行了一项前瞻性队列研究。根据患者数量采用概率抽样法随机选择患者入组。纳入标准为年龄19 - 75岁且能够提供知情同意书。醉酒或处于危急状态的患者被排除。在获得知情同意并进行简短的检测前咨询后，使用INSTI HIV - 1/HIV - 2抗体检测获取参与者的HIV状态。参与者完成一份关于HIV风险行为和对急诊科HIV检测满意度的问卷。检测结果呈阳性的参与者或进行其他血液检测的参与者接受确证性免疫印迹检测。HIV检测呈阳性的参与者被立即转介至HIV专科诊所。
共邀请了2077名患者，1402名（67.5%）同意参与。参与者的平均年龄为43.3岁，58.4%的参与者为男性。基于即时检测的HIV抗体血清流行率为65/1402（4.6%；95%置信区间：3.5% - 5.8%）。在我们的队列中未发现新的HIV诊断病例。患者对即时检测HIV的满意度较高（平均满意度评分9.6/10）。
基于快速的即时HIV抗体检测，市中心急诊科中HIV的血清流行率为4.6%。急诊科的即时检测是可接受的，患者对检测程序的满意度较高。
