Concurrent Testing for COVID-19 and HIV Infection at 6 High-Volume Emergency Departments in a Priority Jurisdiction for Ending the HIV Epidemic in the United States

Moira C. McNulty, Kimberly A. Stanford, Dylan Eller, Beverly E. Sha, Yanina Purim-Shem-Tov, Ekta Kishen, Nancy Glick, Bijou Hunt, Janet Y. Lin, Anjana Maheswaran, Shannon Galvin, Robert Turelli, Jessica Schmitt, David Pitrak

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background:The COVID-19 pandemic caused disruptions in access to routine HIV screening.Setting:We assess HIV and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing across 6 emergency departments (EDs) in Cook County, Illinois.Methods:We retrospectively analyzed the number of SARS-CoV-2 tests, HIV screens, and the proportion of concurrent tests (encounters with both SARS-CoV-2 and HIV testing), correlating with diagnoses of new and acute HIV infection.Results:Five sites reported data from March 1, 2020, to February 28, 2021, and 1 site from September 1, 2020, to February 28, 2021. A total of 1,13,645 SARS-CoV-2 and 36,094 HIV tests were performed; 17,469 of these were concurrent tests. There were 102 new HIV diagnoses, including 25 acute infections. Concurrent testing proportions ranged from 6.7% to 37% across sites (P < 0.001). HIV testing volume correlated with the number of new diagnoses (r = 0.66, P < 0.01). HIV testing with symptomatic SARS-CoV-2 testing was strongly correlated with diagnosis of acute infections (r = 0.87, P < 0.001); this was not statistically significant when controlling for HIV testing volumes (r = 0.59, P = 0.056). Acute patients were more likely to undergo concurrent testing (21/25) versus other new diagnoses (29/77; odds ratio = 8.69, 95% CI: 2.7 to 27.8, P < 0.001).Conclusions:Incorporating HIV screening into SARS-CoV-2 testing in the ED can help maintain HIV screening volumes. Although all patients presenting to the ED should be offered opt-out HIV screening, testing individuals with symptoms of COVID-19 or other viral illness affords the opportunity to diagnose symptomatic acute and early HIV infection, rapidly link to care, and initiate treatment.

Original languageEnglish (US)
Pages (from-to)364-370
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume94
Issue number4
DOIs
StatePublished - Dec 1 2023

Funding

The Expanded HIV Testing and Linkage to Care Program is funded by the Chicago Department of Public Health. Additional support is provided through Gilead's Frontlines of Communities in the United States (FOCUS) program. MCM is supported by the National Institutes of Health (K23MH118969). K.A.S. is supported by the National Institutes of Health (K23AI166277). B.E.S., Y.P.-S.-T., N.G., J.Y.L., S.G., J.S., and D.P. report grant support, and M.C.M. has served on an advisory board for Gilead Sciences, Inc. The Expanded HIV Testing and Linkage to Care Program is funded by the Chicago Department of Public Health. Additional support is provided through Gilead's Frontlines of Communities in the United States (FOCUS) program. MCM is supported by the National Institutes of Health (K23MH118969). K.A.S. is supported by the National Institutes of Health (K23AI166277). B.E.S., Y.P.-S.-T., N.G., J.Y.L., S.G., J.S., and D.P. report grant support, and M.C.M. has served on an advisory board for Gilead Sciences, Inc.

Keywords

  • COVID-19
  • HIV screening
  • SARS-CoV-2 testing
  • acute HIV infection
  • emergency medicine

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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