The Journal of Emergency Medicine
Volume 42, Issue 1 , Pages 7-14 , January 2012

Emergency Provider Attitudes and Barriers to Universal HIV Testing in the Emergency Department

  • Christian Arbelaez, MD, MPH

      Affiliations

    • Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    • Corresponding Author InformationReprint Address: Christian Arbelaez, md, mph, Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115
    • ,
  • Elizabeth A. Wright, PHD

      Affiliations

    • Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • Elena Losina, PHD

      Affiliations

    • Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • Jennifer C. Millen, MD, MPH

      Affiliations

    • Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • Simeon Kimmel, BA

      Affiliations

    • Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • Matthew Dooley, BA

      Affiliations

    • Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • William M. Reichmann, MA

      Affiliations

    • Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
    • Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
    • ,
  • Regina Mikulinsky, MBA

      Affiliations

    • Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • Rochelle P. Walensky, MD, MPH

      Affiliations

    • Division of Infectious Disease, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    • Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
    • Division of General Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
    • Center for AIDS Research, Harvard Medical School, Boston, Massachusetts

Received 19 November 2008 ,Revised 29 May 2009 ,Accepted 23 July 2009.

References 

  1. Branson BM , Handsfield HH , Lampe MA , et al.  Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings . MMWR Recomm Rep . 2006;55:1–17
  2. American College of Emergency Physicians . HIV testing and screening in the emergency department . Ann Emerg Med . 2007;50:209
  3. Scott BC . Emergency departments: an important component of public health . J Natl Med Assoc . 1995;87:181–183
  4. Larkin GL , Hyman KB , Mathias SR , et al.  Routine screening for intimate partner violence in the emergency department: Importance of patient and provider factors . Ann Emerg Med . 1999;33:669–675
  5. Ellis JM . Barriers to effective screening for domestic violence by registered nurses in the emergency department . Crit Care Nurs Q . 1999;22:27–41
  6. Williams JM , Chinnis AC , Gutman D . Health promotion practices of emergency physicians . Am J Emerg Med . 2000;18:17–21
  7. Davis RE , Harsh KE . Confronting barriers to routine screening for domestic violence . J Prof Nurs . 2001;17:313–320
  8. Hungerford DW , Williams JM , Furbee PM , et al.  Feasibility of screening and intervention for alcohol problems among young adults in the ED . Am J Emerg Med . 2003;21:14–22
  9. Nordqvist C , Johansson K , Lindqvist K , et al.  Attitude changes among emergency department triage staff after conducting routine alcohol screening . Addict Behav . 2006;31:191–202
  10. Yonaka L , Yoder MK , Darrow JB , et al.  Barriers to screening for domestic violence in the emergency department . J Contin Educ Nurs . 2007;38:37–45
  11. McCann TV , Clark E , McConnachie S , et al.  Deliberate self-harm: emergency department nurses' attitudes, triage and care intentions . J Clin Nurs . 2007;16:1704–1711
  12. Furniss K , McCaffrey M , Parnell V , Rovi S . Nurses and barriers to screening for intimate partner violence . MCN Am J Matern Child Nurs . 2007;32:238–243
  13. Borg KT . To test or not to test? (HIV, emergency departments, and the new Centers for Disease Control and Prevention guidelines) . Ann Emerg Med . 2007;49:573–574
  14. Rothman RE , Lyons MS , Haukoos JS . Uncovering HIV infection in the emergency department: a broader perspective . Acad Emerg Med . 2007;14:653–657
  15. Peckler B . Emergency department HIV testing: sounds good, but . . .? . Acad Emerg Med . 2003;10:1415–1416 author reply 1416–7
  16. Irvin CB , Flagel BT , Fox JM . The emergency department is not the ideal place for routine HIV testing . Ann Emerg Med . 2007;49:722
  17. Brown J , Shesser R , Simon G . Establishing an ED HIV screening program: lessons from the front lines . Acad Emerg Med . 2007;14:658–661
  18. Brown J , Shesser R , Simon G , et al.  Routine HIV screening in the emergency department using the new US Centers for Disease Control and Prevention guidelines: results from a high prevalence area . J Acquir Immune Defic Syndr . 2007;46:395–401
  19. Lyss SB , Branson BM , Kroc KA , et al.  Detecting unsuspected HIV infection with a rapid whole-blood HIV test in an urban emergency department . J Acquir Immune Defic Syndr . 2007;44:435–442
  20. Mehta SD , Hall J , Lyss SB , et al.  Adult and pediatric emergency department sexually transmitted disease and HIV screening: programmatic overview and outcomes . Acad Emerg Med . 2007;14:250–258
  21. Centers for Diseases Control and Prevention (CDC) . Missed opportunities for earlier diagnosis of HIV infection—South Carolina, 1997–2005 . MMWR Morb Mortal Wkly Rep . 2006;55:1269–1272
  22. Paltiel AD , Walensky RP , Schackman BR , et al.  Expanded HIV screening in the United States: effect on clinical outcomes, HIV transmission, and costs . Ann Intern Med . 2006;145:797–806
  23. Walensky RP , Weinstein MC , Smith HE , Freedberg KA , Paltiel AD . Optimal allocation of testing dollars: the example of HIV counseling, testing, and referral . Med Decis Making . 2005;25:321–329

 This research was funded by the National Institute of Mental Health (R01 MH0735445, R01 MH65869) and the Doris Duke Charitable Foundation (Clinical Scientist Development Award to Rochelle P. Walensky, md, mph), ClinicalTrials.Gov: #NCT00502944.

PII: S0736-4679(09)00677-5

doi: 10.1016/j.jemermed.2009.07.038

The Journal of Emergency Medicine
Volume 42, Issue 1 , Pages 7-14 , January 2012

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