The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, May 9, 2006
165

Evaluation of the feasibility and acceptability of implementing an STD and Rapid HIV testing program in an urban urgent care center

Ellen T. Rudy1, Chandra Higgins2, Lisa Smith2, Guillermo Campos2, Cynthia Davison2, Jeanette Brown3, Regina Umukoro3, and Peter Kerndt2. (1) Sexually Transmitted Disease Program, Los Angeles County Department of Public Health, 2615 S. Grand Ave., Room 500, Los Angeles, CA, USA, (2) Sexually Transmitted Disease Program, Los Angeles County Department of Health Services, 2615 S. Grand Ave #500, Los Angeles, CA, USA, (3) Martin Luther King-Drew Medical Center, Los Angeles, CA


Background:
Screening for STDs and HIV in urgent care settings provide an opportunity for early identification and treatment of STD/HIV infections.

Objective:
To determine the feasibility and acceptability of STD/HIV screening and direct linkage to HIV medical care in an urban urgent care setting.

Method:
From October 2003 through September 2004, 2,247 urgent care patients were offered rapid HIV and STD testing at the Los Angeles County King-Drew Medical Center. Eligible patients were between 18 and 54 years old and spoke English. Logistic regression was used to estimate predictors of STD/HIV morbidity.

Result:
1,002 (60%) patients were tested with rapid HIV OraQuick®, 794 (47%) patients were tested for Chlamydia (CT)/gonorrhea (GC) with the Aptima Combo 2 Assay urine test. There were 14 (1.4%) HIV positive cases of which 6 were newly identified, 25 (3.1%) CT, 14 (1.8%) GC, and 3(<1%) co-infections. Ten (71%) HIV positive cases were linked to treatment. Of the CT/GC positive cases, 31 (84%) received treatment for their STD infection; 5 (14%) were unable to locate, and 3 (10%) were outside the health department jurisdiction. Patients who tested as a result of provider referrals were 6.8 times more likely to be HIV positive than non-referral patients. Having recently tested and in “too much pain” were the primary reasons patients refused the testing services.

Conclusion:
STD and rapid HIV screening program in the urgent care setting was acceptable and feasible to implement and resulted in the identification treatment or referral of previously unrecognized morbidity.

Implications:
Urban urgent care settings provide an opportunity to identify persons at high-risk for unidentified HIV/STDs and without a regular source of health care.