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Date Posted: 12:30:48 05/16/02 Thu
Author: Anonymous
Subject: Study Supports Voluntary Inpatient HIV Screening

http://www.medscape.com/viewarticle/432626_print

Study Supports Voluntary Inpatient HIV Screening

Laurie Barclay, MD

MedscapeWire 2002. � 2002 Medscape Portals, Inc
Introduction
NEW YORK (MedscapeWire) Apr 26 ? The Centers for Disease Control and Prevention (CDC) recommends voluntarily screening all inpatients for HIV, according to an article in the April 22 issue of the Archives of Internal Medicine . At Boston Medical Center, this testing program detected 2 new cases per month, compared with 1 case per month before testing was routinely offered.

"The stigma associated with HIV infection continues to plague aggressive testing endeavors," write Rochelle P. Walensky, MD, MPH, from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues. "It is our hope that with widespread screening for HIV and treatment of infected persons, the stigma associated with testing will decrease."

Because HIV testing efforts that target only symptomatic patients fail to identify the one-third of HIV-seropositive people in the United States who are asymptomatic, the Think HIV program offered voluntary HIV counseling and testing to all patients admitted to the medical service of Boston Medical Center.

Patients admitted during the 15-month program period were 3.4 times more likely to undergo testing for HIV than were those admitted during a comparable control period (6.4% vs 2%). This testing program detected approximately 2 new cases of HIV infection monthly compared with 1 case per month during the control period. Estimated prevalence of HIV infection was 3.8% in patients tested during the program, who likely would have declined testing without this initiative.

"This study explores the impact of implementing the recommended CDC policy of routine inpatient HIV testing," the authors write, noting that their outcomes analysis supports the vast expense of expanding this testing initiative nationally. "Physicians must make the commitment to enroll patients in such a testing program if it is to have an impact. This study can serve as an example for other facilities to establish similar screening efforts so that most of the estimated 300,000 people with undiagnosed HIV infection in the United States can be identified and provided with appropriate care."

Arch Intern Med.2002;162(8):887-892

Reviewed by Gary D. Vogin, MD

Laurie Barclay, MD, is a staff writer with WebMD.

MedscapeWire is edited by Deborah Flapan, an associate editor at Medscape. Please send press releases and comments to MedscapeWire@exchange.webmd.net.

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