Effect of Opt-Out HIV Testing for Adolescent Patients on a Pediatric Hospital Medicine Service.
Opt-out HIV screening with navigators increased adolescent testing on pediatric hospital wards
Effect of Opt-Out HIV Testing for Adolescent Patients on a Pediatric Hospital Medicine Service.
In 2023, our emergency department, serving a region with one of the highest rates of new HIV infection, implemented Centers for Disease Control and Prevention-recommended universal, opt-out HIV screening for adolescents.
To address this gap, we aimed to expand universal, opt-out HIV testing to PHM and evaluate screening implementation.
In this pre-postintervention study, we compared HIV testing rates for patients admitted to PHM aged 13 years or older during 5 months preimplementation and postimplementation (February to June 2024 and July to November 2024).
HIV screening rose after adding opt-out testing with navigators
Postimplementation, 533 adolescents were eligible for HIV screening; 148 were approached, and 91 HIV tests were ordered (17.1% of eligible; 64% girls; mean age 16 ± 1.8 years), identifying one adolescent with HIV (>1% seroprevalence; 3% for boys).
Adolescents were significantly more likely to be tested when approached by an HIV navigator than during a confidential interview (P = .004).
Parental presence did not negatively impact adolescent participation.
Adopting universal, opt-out HIV screening with HIV navigators in the inpatient setting significantly increased testing rates. Further studies on the most effective and sustainable approach to screening are needed.