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The CDC and national research
organizations have recommended universal HIV screening, but physicians disagree
on how to implement testing in busy emergency departments. Researchers at the
University of Cincinnati Medical Center Emergency Department conducted a
randomized trial to determine whether screening everyone in the emergency
department was more efficient than targeted testing screening.
The researchers hypothesized that by
using very broad criteria and applying sufficient resources to test all who met
the criteria they would be able to detect almost as many individuals with HIV
infection as in universal screening, and use fewer tests. In the trial,
patients for universal screening were offered HIV testing regardless of risk
factors whereas with patients for targeted screening researchers set very broad
parameters and offered testing for any possible risk indicator they found using
more criteria than usual.
The researchers offered screening to
9,572 patients who were randomized into either category. Results showed that
targeted screening did not diagnose as many patients and did not require many
fewer tests. Approximately 40 percent of universally screened individuals
agreed to be tested and six of them tested positive for HIV. In the targeted
screening group 47 percent agreed to be testing and three were diagnosed
positive.
According to Michael Lyons, lead
author of the study, results showed that this type of targeted screening using
the broadest possible selection criteria was not better than universal
screening. He acknowledged additional studies are needed to determine whether
another method of selecting patients for screening would be more successful in
limiting testing while finding more infected individuals.
The full report, “Randomized
Comparison of Universal and Targeted HIV Screening in the Emergency
Department,” was published online in the journal Acquired Immune Deficiency
Syndromes (doi: 10.1097/QAI.0b013e3182a21611).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus.
To learn more about The Friends of
AIDS Foundation, please visit: http://www.friendsofaids.org.
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