Scope of Rapid HIV Testing in Urban U. S. Hospitals

Published In: Public Health Reports, v. 123, no. 4, July/Aug. 2008, p. 494-503

Posted on RAND.org on January 01, 2008

by Laura M. Bogart, Devery Howerton, James Lange, Kirsten Becker, Claude Messan Setodji, Steven M. Asch

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OBJECTIVE: The present study examined the scope of rapid human immunodeficiency virus (HIV) testing in urban U.S. hospitals. METHODS: In a multistage national probability sample, 12 primary metropolitan statistical areas (three per region) were sampled randomly, with weights proportionate to acquired immunodeficiency syndrome (AIDS) populations. All 671 eligible hospitals within areas were selected. Laboratory staff from 584 hospitals (87%) were interviewed by telephone in 2005. RESULTS: About 52% reported rapid HIV test availability (50% in occupational health, 29% in labor and delivery, and 13% in emergency department/urgent care), and 86% of hospitals offering rapid tests processed them in the laboratory. In multivariate models, rapid test availability was more likely in hospitals serving more patients, and located in high-poverty, high-AIDS prevalence areas, and in the South or Midwest vs. West. It was less likely in hospitals serving areas with large percentages of people who were black/African American or Hispanic/Latino (p,0.05). CONCLUSIONS: Rapid HIV testing is increasing across urban U.S. hospitals, primarily for occupational exposure and in hospitals with greater resources and need. To achieve routine HIV screening, policies should encourage greater breadth of diffusion of rapid testing at the point of care, especially in smaller facilities, the West, and communities with racial/ethnic diversity.

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