HIV testing within emergency departments: A descriptive study assessing barriers and potential solutions

This study examined individual practices of emergency department (ED) health care providers in regard to HIV testing and identified barriers to routine offering of HIV tests and potential solutions to overcoming those barriers. The study also looked at the association between demographic characteristics to offering testing. Via mail, 349 health care providers in EDs located in metropolitan areas of the United States with AIDS case rates ≥15 per 100,000 were surveyed. Surveys from 223 ED health care providers (64%) were completed, returned, and included in the analysis. Only 3.14% (n = 7) of those surveyed indicated that they routinely offered an HIV test to all persons who sought care in the ED; 28% (n = 64) offered tests to persons at risk, 53.36%, (n = 119) offered to persons presenting with symptoms of HIV infection, and 26.01% ( n = 58) routinely referred for HIV testing. Nearly all providers (93.27%; n = 208) did not offer an HIV test to pregnant women. The greatest barriers to routine offering of HIV tests were: concern about logistics for follow up (M = 3.38, SD = 0.74) and posttest counseling requirements (M = 3.36, SD = 0.67). The top solution to overcoming the barriers was access to rapid screening tests (M = 3.14, SD = 0.80). Among the demographic differences there were only two values of significance, the ED health care providers number of years in practice F(4, 223) = 11.62, p = <0.0005 and routinely offering an HIV test to all pregnant women by practice setting x2 (4, N = 215) = 87.26, p = 0.0001. These results make it clear that ED health care providers do not routinely offer HIV testing. There are many barriers to routine testing but there are solutions that might assist in overcoming the barriers.