Simplifying Consent for HIV Testing Is Associated with an Increase in HIV Testing and Case Detection in Highest Risk Groups, San Francisco January 2003–June 2007
Open Access
- 2 July 2008
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 3 (7), e2591
- https://doi.org/10.1371/journal.pone.0002591
Abstract
Populations at highest risk for HIV infection face multiple barriers to HIV testing. To facilitate HIV testing procedures, the San Francisco General Hospital Medical Center eliminated required written patient consent for HIV testing in its medical settings in May 2006. To describe the change in HIV testing rates in different hospital settings and populations after the change in HIV testing policy in the SFDH medical center, we performed an observational study using interrupted time series analysis. Data from all patients aged 18 years and older seen from January 2003 through June 2007 at the San Francisco Department of Public Health (SFDPH) medical care system were included in the analysis. The monthly HIV testing rate per 1000 hadpatient-visits was calculated for the overall population and stratified by hospital setting, age, sex, race/ethnicity, homelessness status, insurance status and primary language. By June 2007, the average monthly rate of HIV tests per 1000 patient-visits increased 4.38 (CI, 2.17–6.60, p<0.001) over the number predicted if the policy change had not occurred (representing a 44% increase). The monthly average number of new positive HIV tests increased from 8.9 (CI, 6.3–11.5) to 14.9 (CI, 10.6–19.2, p<0.001), representing a 67% increase. Although increases in HIV testing were seen in all populations, populations at highest risk for HIV infection, particularly men, the homeless, and the uninsured experienced the highest increases in monthly HIV testing rates after the policy change. The elimination of the requirement for written consent in May 2006 was associated with a significant and sustained increase in HIV testing rates and HIV case detection in the SFDPH medical center. Populations facing the higher barriers to HIV testing had the highest increases in HIV testing rates and case detection in response to the policy change.Keywords
This publication has 11 references indexed in Scilit:
- Trends in HIV Testing and Differences Between Planned and Actual Testing in the United States, 2000-2005Archives of Internal Medicine, 2007
- Detecting Unsuspected HIV Infection With a Rapid Whole-Blood HIV Test in an Urban Emergency DepartmentJAIDS Journal of Acquired Immune Deficiency Syndromes, 2007
- Association Between Rates of HIV Testing and Elimination of Written Consents in San FranciscoJAMA, 2007
- Racial/ethnic disparities in diagnoses of HIV/AIDS--33 states, 2001-2005.2007
- Late Diagnosis of HIV InfectionJAIDS Journal of Acquired Immune Deficiency Syndromes, 2006
- Faculty Opinions recommendation of Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings.Published by H1 Connect ,2006
- Human immunodeficiency virus counseling and testing practices among North Carolina providersObstetrics & Gynecology, 2002
- Segmented regression analysis of interrupted time series studies in medication use researchJournal of Clinical Pharmacy & Therapeutics, 2002
- HIV in the United States at the turn of the century: an epidemic in transitionAmerican Journal of Public Health, 2001
- Attitudes to HIV testing in general practiceInternational Journal of STD & AIDS, 1998