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Opt-out testing at children’s hospitals increases HIV testing rate

ATLANTA — Hospitalwide opt-out testing was successful at increasing the HIV testing rate among children aged 13 years and older at two U.S. children’s hospitals, according to data presented at the CDC’s National HIV Prevention Conference.

“Hospitalwide routine opt-out testing is possible in a children’s hospital and its clinics, and it can be very effective in identifying new HIV infections,” Ann Petru, MD, FAAP, director of infectious diseases and the pediatric HIV/AIDS program at the University of California, San Francisco Benioff Children’s Hospital Oakland, told Infectious Diseases in Children. “The process may be challenging to set up initially, but it is replicable in other hospitals and clinic settings. Hopefully, it will be self-sustaining beyond our period of funding.”

Petru and colleagues implemented routine opt-out testing at the adolescent medicine sites, inpatient care sites, primary care sites and EDs at St. Christopher’s Hospital for Children in Philadelphia in 2010, and at Benioff in 2014. A network of onsite physicians and nurses responsible for the promotion of opt-out testing was developed, and prompts were added to electronic medical record systems. Researchers from both hospitals compared data after 1 year of testing was completed at each site.

Study results showed that after 1 year, there were 2,231 patients tested at St. Christopher’s and 2,880 at Benioff, representing 16.8% and 25.2% of eligible patients, respectively. It translated to a 7.2% increase in testing at Benioff compared with the previous year. This program also resulted in the identification of three new HIV-infected patients at St. Christopher’s, including one acute case, and four seropositive patients, two with acute HIV-infection, at Benioff.

Petru said patient confidentiality issues were “at times difficult,” particularly in the ER, and staff training at the hospitals was time-consuming.

“Looking forward, our intent is that everyone in our community knows their HIV status,” Petru said. “To achieve that, regardless of the reason our patients access care, they will be tested for HIV on a routine, ongoing basis.” – by David Costill

Reference: Petru A, et al. Abstract 2180. Presented at: National HIV Prevention Conference; Dec. 6-9, 2015; Atlanta.

Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures at the time of publication.