Routine Screening for HIV in an Urban Emergency Department During the COVID-19 Pandemic
- PDF / 1,001,071 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 105 Downloads / 156 Views
NOTES FROM THE FIELD
Routine Screening for HIV in an Urban Emergency Department During the COVID‑19 Pandemic Kimberly A. Stanford1 · Eleanor E. Friedman2 · Jessica Schmitt2 · Thomas Spiegel1 · Jessica P. Ridgway2 · Michelle Moore2 · Michelle Taylor2 · David Pitrak2 · Moira C. McNulty2
© Springer Science+Business Media, LLC, part of Springer Nature 2020
The emergency department (ED) has been identified as a key location for HIV screening, with many new diagnoses resulting from non-targeted ED screening programs [1]. The COVID-19 pandemic has greatly affected ED operations across the country. Many EDs have seen dramatic increases in patient volumes, while others have experienced a lull, as only the most serious cases continue to arrive at the ED. Preparedness for and management of COVID-19 are clearly emergent public health priorities, but other important public health initiatives, such as expanded HIV screening and linkage to care, must continue. Routine HIV screening in the ED faces many barriers in normal times, due to competing priorities and complexities of implementation [2]. The COVID-19 pandemic presents further challenges to routine screening programs. We describe how our urban ED in Chicago, with advance planning, was able to continue routine HIV screening in the face of the COVID-19 pandemic.
HIV Screening Program and ED Design The University of Chicago has had a program for expanded HIV testing and linkage to care at our hospitals and clinics since 2011. Recently that program has placed special emphasis on screening in the ED, utilizing automated electronic medical record (EMR) reminders to support test ordering. All ED patients under age 65 who have no known diagnosis of HIV and have not been tested for HIV in the last year are eligible for screening. The HIV care team assumes all * Kimberly A. Stanford [email protected] 1
Section of Emergency Medicine, Department of Medicine, University of Chicago, Chicago, IL, USA
Section of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA
2
responsibility for positive test result notification, linkage to care, and initiation of antiretroviral therapy (ART). In preparation for the COVID-19 pandemic, our ED quickly established a large temporary space for screening, testing, and treatment of patients with influenza-like illness (ILI) who were considered likely to be discharged home. With support of ED leadership, continued HIV screening of patients was incorporated into the design of this secondary ED space, with a station for lab draws designated for HIV screening. This space otherwise has extremely limited diagnostic capacity, with capabilities only for chest x-ray, EKG, viral swab, and strep swabs (Fig. 1). There was initially some resistance to HIV testing on the part of staff, many of whom felt that COVID-19 should be the sole priority. However, ED leadership offered provider education regarding the overlap of symptoms between COVID-19 and acute HIV and emphasized the opportunity f
Data Loading...
