Routinely Offering HIV Tests to People in Hospitals Helps More People Get Tested, and Know Their Status

For about eight months in 2014 and 2015, a medical care center in the Bronx prompted hospital health care providers, through an electronic medical records system, to offer HIV tests to patients. It wasn't a blanket recommendation, and patients had to opt-in to the HIV testing once it was offered, but it did significantly expand HIV testing and diagnose many people living with HIV who were unaware of their status.

Perhaps not surprisingly, the results of this expanded screening were beneficial: The HIV test reminder program increased the likelihood that HIV tests were provided to people admitted to hospitals. Importantly, the program also increased the percentage of new positive HIV diagnoses by about 3.5-fold. During the standard of care period, the rate of positive HIV diagnoses was 8.2 (per 100,000); during the testing program, this rate rose to 37 (per 100,000).

The expanded testing program was relatively simple. It involved an electronic prompt that health care providers received, reminding them to offer an HIV test to eligible patients. Reminders were offered for an HIV test if a patient either had no HIV test result recorded in their file, or, if they had an indicator of HIV risk recorded (e.g., a sexually transmitted infection diagnosis) since their last HIV test. HIV counselors on staff responded to HIV test requests and provided services in English and Spanish.

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