Tuesday, March 9, 2010: 3:45 PM
Dogwood A (M1) (Omni Hotel)
Susan Blank, MD, MPH1, Alexis V. Kowalski, MPH
2, Jessica M. Borrelli, MPH
3, Steven R. Rubin
1, Thomas G. Merrill, JD
4 and Susan Wright
5, 1Bureau of STD Control, New York City Department of Health and Mental Hygiene, New York, NY, 2Bureau of STD Control and Prevention;, NYC Department of health & Mental Hygiene, New York, NY, 3Bureau of Sexually Transmitted Disease Control, NYC Department of Health and Mental Hygiene, New York, NY, 4Office of the General Counsel, NYC Department of Health & Mental Hygiene, New York, NY, 5Bureau of STD Control & Prevention, NYC Department of Health & Mental Hygiene, New York, NY
Background: STD clinics are important venues for identifying persons with HIV infection. In NYC STD clinics, HIV test volumes increased following the introduction of HIV rapid tests and streamlined pre-test counseling in 2005. Although NY State mandates separate, written consent for HIV testing, in January 2008, we introduced a State-approved consent form, combining general consent for STD care and HIV testing (“Combo Consent”); the form includes an ‘opt out’ checkbox for HIV testing.
Objectives: To measure the impact of the combined consent on the proportion of patients leaving the NYC STD clinics knowing their HIV status.
Methods: Using data from the STD clinic electronic medical record, we measured the proportion of patients knowing their HIV status by the end of clinic visit before and after introduction of the combined consent. “Known HIV status” was defined as: an HIV test done on the date of visit; a self-reported or documented positive HIV test result; or a negative HIV test performed and documented within 3 months of patient’s visit. Results:
The percent of patients leaving our clinics with a known HIV status increased from 69% (64,648/ 94,226) in 2006, to 73% ( 73,300/ 100,881) in 2007, to 80% (88,672/ 110,408) in 2008, and to 85% (99,492/ 116,716) thus far in 2009 (p<0.00001, chi square for trend); increases were similar by sex. Increases are almost exclusively attributable to increases in HIV testing on the day of visit. Conclusions:
Combining the HIV consent process with general consent for STD care and including an HIV “opt out” check box can improve screening rates and number of HIV-infected cases identified. Implications for Programs, Policy, and/or Research:
Minimizing barriers and normalizing HIV testing can maximize HIV case identification among patients seeking care in STD clinics, thus improving control of HIV and STDs
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