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Routine Screening for HIV Infection in a Low Risk Population

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DOI: 10.4236/aid.2012.22004    4,257 Downloads   7,659 Views   Citations

ABSTRACT

Context: Despite advances in therapy for HIV infection, treatment is often compromised by delayed diagnosis. Strate-gies are needed to improve broad based testing in all medical settings. Objective: To compare HIV screening rates in a primary care setting following implementation of an electronic reminder system to rates produced solely by provider educational efforts. Design: Prospective, observational study of HIV screening, comparing rates during implementation of strategies. Setting: Multiple clinic healthcare system affiliated with a tertiary care medical center. Patients: Veterans receiving care in the clinics affiliated with the Department of Veterans Affairs-Eastern Colorado Healthcare System. Intervention: Provider education and a provider clinical reminder system embedded in the electronic medical record. Main Outcome Measure: Proportion of primary care clinic appointments at which the veteran was screened for HIV infection. Results: The proportion of visits at which screening occurred increased from 2.7% during the provider edu-cation period to 16.7% during the provider clinical reminder period (p < 0.0001). All of the cases identified by the re-minder were antiretroviral therapy candidates, and there was a trend to earlier diagnosis in the screening group than in the diagnostic testing group (CD4 count 329 vs. 109, p = 0.13). Conclusions: An electronic clinical reminder system in a primary care setting is an effective strategy to increase testing for HIV infection, and may lead to fewer delayed diag-noses.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

M. Bessesen, P. Stamper, J. Shaw, N. Ojha, A. Currans, D. Weinshenker and D. Merrick, "Routine Screening for HIV Infection in a Low Risk Population," Advances in Infectious Diseases, Vol. 2 No. 2, 2012, pp. 19-24. doi: 10.4236/aid.2012.22004.

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