Ford James S, Mousa Mohammad A, Voong Stephanie, Matsumoto Cynthia G, Chechi Tasleem, Tran Nam, May Larissa
Department of Emergency Medicine, University of California San Francisco, San Francisco, CA, USA
Department of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Sex Transm Infect. 2023 Aug 17;99(6):404-408. doi: 10.1136/sextrans-2022-055513.
In 2019, the US Preventative Services Task Force released updated guidelines recommending HIV screening in all individuals aged 15-64 years and all pregnant females. In the current study, we aimed to identify risk factors for HIV infection in an emergency department (ED) population.
We performed a cross-sectional study that employed a post hoc risk factor analysis of ED patients ≥18 years who were screened for HIV between 27 November 2018 and 26 November 2019, at a single urban, quaternary referral academic hospital. Patients were screened using HIV antigen/antibody testing and diagnoses were confirmed using HIV-1/HIV-2 antibody testing. The outcome of interest was the number of positive HIV tests. Multiple logistic regression models were used to identify risk factors associated with HIV positivity.
14 335 adult patients were screened for HIV (mean age: 43±14 years; 52% female). HIV seroprevalence was 0.7%. Independent risk factors for HIV positivity included male sex (adjusted OR (aOR) 3.1 (95% CI 1.7 to 5.6)), unhoused status (aOR 2.9 (95% CI 1.7 to 4.9)), history of illicit drug use (aOR 1.8 (95% CI 1.04 to 3.13)) and Medicare insurance status (aOR 2.2 (95% CI 1.1 to 4.4)).
The study ED services a high-risk population with regard to HIV infection. These data support universal screening of ED patients for HIV. Risk factor profiles could improve targeted screening at institutions without universal HIV testing protocols.
2019年，美国预防服务工作组发布了更新指南，建议对所有15至64岁的个体以及所有怀孕女性进行HIV筛查。在本研究中，我们旨在确定急诊科人群中HIV感染的危险因素。
我们进行了一项横断面研究，对2018年11月27日至2019年11月26日期间在一家城市四级转诊学术医院接受HIV筛查的18岁及以上急诊科患者进行事后危险因素分析。患者采用HIV抗原/抗体检测进行筛查，并使用HIV-1/HIV-2抗体检测确诊。感兴趣的结果是HIV检测呈阳性的数量。使用多元逻辑回归模型确定与HIV阳性相关的危险因素。
14335名成年患者接受了HIV筛查（平均年龄：43±14岁；52%为女性）。HIV血清阳性率为0.7%。HIV阳性的独立危险因素包括男性（调整后的比值比（aOR）3.1（95%置信区间1.7至5.6））、无家可归状态（aOR 2.9（95%置信区间1.7至4.9））、非法药物使用史（aOR 1.8（95%置信区间1.04至3.13））和医疗保险状态（aOR 2.2（95%置信区间1.1至4.4））。
该研究中的急诊科为HIV感染的高危人群提供服务。这些数据支持对急诊科患者进行普遍的HIV筛查。危险因素概况可改善没有普遍HIV检测方案的机构的针对性筛查。
