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

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

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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