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Pilot Integration of HIV Screening and Healthcare Settings with Multi- Component Social Network and Partner Testing for HIV Detection

[ Vol. 15 , Issue. 5 ]

Author(s):

Michael F. Rentz, Andrew H. Ruffner, Rachel M. Ancona, Kimberly W. Hart, John R. Kues, Christopher M. Barczak, Christopher J. Lindsell, Carl J. Fichtenbaum and Michael S. Lyons*   Pages 372 - 381 ( 10 )

Abstract:


Background: Healthcare settings screen broadly for HIV. Public health settings use social network and partner testing (‚ÄúTransmission Network Targeting (TNT)‚ÄĚ) to select high-risk individuals based on their contacts. HIV screening and TNT systems are not integrated, and healthcare settings have not implemented TNT.

Objective: The study aimed to evaluate pilot implementation of multi-component, multi-venue TNT in conjunction with HIV screening by a healthcare setting.

Methods: Our urban, academic health center implemented a TNT program in collaboration with the local health department for five months during 2011. High-risk or HIV positive patients of the infectious diseases clinic and emergency department HIV screening program were recruited to access social and partner networks via compensated peer-referral, testing of companions present with them, and partner notification services. Contacts became the next-generation index cases in a snowball recruitment strategy.

Results: The pilot TNT program yielded 485 HIV tests for 482 individuals through eight generations of recruitment with five (1.0%; 95% CI = 0.4%, 2.3%) new diagnoses. Of these, 246 (51.0%; 95% CI = 46.6%, 55.5%) reported that they had not been tested for HIV within the last 12 months and 383 (79.5%; 95% CI = 75.7%, 82.9%) had not been tested by the existing ED screening program within the last five years.

Conclusion: TNT complements population screening by more directly targeting high-risk individuals and by expanding the population receiving testing. Information from existing healthcare services could be used to seed TNT programs, or TNT could be implemented within healthcare settings. Research evaluating multi-component, multi-venue HIV detection is necessary to maximize complementary approaches while minimizing redundancy.

Keywords:

Emergency service, hospital, HIV infections, mass screening, contact tracing, social networks.

Affiliation:

University of Cincinnati College of Medicine, Cincinnati, OH, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, Department of Family and Community Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, Division of Infectious Diseases, University of Cincinnati College of Medicine, Cincinnati, OH, Department of Emergency Medicine, 231 Albert Sabin Way, University of Cincinnati Medical Center, PO Box 670769, Cincinnati, OH 45267-0769

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