Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA.
Department of Epidemiology, Surveillance, and Informatics, Cuyahoga County Board of Health, Cleveland, OH, USA.
Am J Clin Pathol. 2023 Mar 13;159(3):225-227. doi: 10.1093/ajcp/aqac168.
Conducting human immunodeficiency virus (HIV) testing in emergency departments (EDs) can be an effective approach to testing and reaching populations at highest risk of contracting HIV.
All gonorrhea and chlamydia (G/C) and HIV tests ordered in the Cleveland Clinic Health System's 14 EDs were included in the analysis. Data were collected from electronic health records. Descriptive statistics, with medians and means, were computed.
From January 1, 2019, to December 31, 2021, we reviewed ED visits for the purpose of sexually transmitted infection (STI) screening, with an emphasis on G/C screening. In October 2019, both HIV rapid testing and G/C testing began across all 14 Cleveland Clinic EDs. The overall rate of co-testing for HIV when obtaining a G/C test for STI evaluation increased overall to around 30% for our health system EDs, with some individual EDs approaching 60%.
The approach the Cleveland Clinic implemented is an effective way to test for HIV in the ED. Local health departments and stakeholders in HIV communities should support and collaborate with EDs in their jurisdictions to accelerate HIV testing initiatives by using an HIV plus G/C co-testing metric.
在急诊科（ED）进行人类免疫缺陷病毒（HIV）检测是一种有效的检测方法，可以接触到感染 HIV 风险最高的人群。
本分析纳入了克利夫兰诊所医疗系统 14 个 ED 中所有淋病和衣原体（G/C）和 HIV 检测订单的数据。从电子健康记录中收集数据。计算了描述性统计数据，包括中位数和平均值。
从 2019 年 1 月 1 日至 2021 年 12 月 31 日，我们回顾了 ED 就诊情况，目的是进行性传播感染（STI）筛查，重点是 G/C 筛查。2019 年 10 月，所有 14 个克利夫兰诊所 ED 均开始进行 HIV 快速检测和 G/C 检测。在我们的医疗系统 ED 中，在进行 STI 评估的 G/C 检测时同时检测 HIV 的总体比例总体上增加到 30%左右，有些个别 ED 接近 60%。
克利夫兰诊所实施的方法是在 ED 中检测 HIV 的有效方法。当地卫生部门和 HIV 社区的利益相关者应支持并与各自辖区的 ED 合作，通过使用 HIV 加 G/C 联合检测指标来加速 HIV 检测计划。
