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      Incorporating HIV Screening With COVID-19 Testing in an Urban Emergency Department During the Pandemic

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          Abstract

          This cohort study reports the results of incorporating HIV screening into COVID-19 testing at the University of Chicago emergency department.

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          Ending the HIV Epidemic

          Anthony Fauci, Robert Redfield, George Sigounas … (2019)
          Article 0 comments Cited 352 times – based on 0 reviews     Review now
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            The potential epidemiological impact of COVID-19 on the HIV/AIDS epidemic and the cost-effectiveness of linked, opt-out HIV testing: A modeling study in six US cities

            Xiao Zang, Emanuel Krebs, Siyuan Chen … (2020)
            Abstract Background Widespread viral and serological testing for SARS-CoV-2 may present a unique opportunity to also test for HIV infection. We estimated the potential impact of adding linked, opt-out HIV testing alongside SARS-CoV-2 testing on HIV incidence and the cost-effectiveness of this strategy in six US cities. Methods Using a previously-calibrated dynamic HIV transmission model, we constructed three sets of scenarios for each city: (1) sustained current levels of HIV-related treatment and prevention services (status quo); (2) temporary disruptions in health services and changes in sexual and injection risk behaviours at discrete levels between 0%-50%; and (3) linked HIV and SARS-CoV-2 testing offered to 10%-90% of the adult population in addition to scenario (2). We estimated cumulative HIV infections between 2020-2025 and incremental cost-effectiveness ratios of linked HIV testing over 20 years. Results In the absence of linked, opt-out HIV testing, we estimated a total of 16.5% decrease in HIV infections between 2020-2025 in the best-case scenario (50% reduction in risk behaviours and no service disruptions), and 9.0% increase in the worst-case scenario (no behavioural change and 50% reduction in service access). We estimated that HIV testing (offered at 10%-90% levels) could avert a total of 576-7,225 (1.6%-17.2%) new infections. The intervention would require an initial investment of $20.6M-$220.7M across cities; however, the intervention would ultimately result in savings in health care costs in each city. Conclusions A campaign in which HIV testing is linked with SARS-CoV-2 testing could substantially reduce HIV incidence and reduce direct and indirect health care costs attributable to HIV.
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              Expanded HIV Testing and Linkage to Care: Conventional vs. Point-of-Care Testing and Assignment of Patient Notification and Linkage to Care to an HIV Care Program.

              Sara Bares, Rebecca Eavou, Clara Bertozzi-Villa … (2016)
              The University of Chicago Medicine (UCM) led the Expanded Testing and Linkage to Care (X-TLC) program for disproportionately affected populations on the South Side of Chicago. The X-TLC program aimed to expand routine HIV testing to high-prevalence communities with disproportionately affected populations (i.e., minority men and women, men who have sex with men, and intravenous drug users) according to CDC guidelines at multiple clinical sites.
              Article 0 comments Cited 12 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): JAMA Intern Med
                Journal ID (iso-abbrev): JAMA Intern Med
                Title: JAMA Internal Medicine
                Publisher: American Medical Association
                ISSN (Print): 2168-6106
                ISSN (Electronic): 2168-6114
                Publication date (Electronic): 12 April 2021
                Publication date (Print): July 2021
                Publication date PMC-release: 12 April 2021
                Volume: 181
                Issue: 7
                Pages: 1001-1003
                Affiliations
                [1 ]Section of Emergency Medicine, The University of Chicago Medicine, Chicago, Illinois
                [2 ]Section of Infectious Diseases and Global Health, The University of Chicago Medicine, Chicago, Illinois
                [3 ]Department of Pathology, The University of Chicago Medicine, Chicago, Illinois
                Author notes
                Article Information
                Accepted for Publication: February 11, 2021.
                Published Online: April 12, 2021. doi:10.1001/jamainternmed.2021.0839
                Open Access: This is an open access article distributed under the terms of the CC-BY-NC-ND License. © 2021 Stanford KA et al. JAMA Internal Medicine.
                Corresponding Author: David Pitrak, MD, Section of Infectious Diseases and Global Health, The University of Chicago Medicine, 5841 S Maryland Ave, MC 5065, Chicago, IL 60637 ( dpitrak@ 123456medicine.bsd.uchicago.edu ).
                Author Contributions: Dr Pitrak had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
                Concept and design: Stanford, McNulty, Eller, Pitrak.
                Acquisition, analysis, or interpretation of data: Stanford, Schmitt, Eller, Ridgway, Beavis, Pitrak.
                Drafting of the manuscript: Stanford, Eller, Pitrak.
                Critical revision of the manuscript for important intellectual content: All authors.
                Statistical analysis: Eller, Pitrak.
                Obtained funding: Schmitt, Pitrak.
                Administrative, technical, or material support: Stanford, McNulty, Schmitt, Beavis.
                Supervision: Schmitt.
                Conflict of Interest Disclosures: Mr Eller reports grants from Gilead Sciences during the conduct of the study and outside of the submitted work. Dr McNulty reports grants from Gilead Sciences outside of the submitted work. Ms Schmitt reports grants from Gilead Sciences as part of the FOCUS (Frontlines of Communities in the United States) Program. Dr Stanford reports grants from the Chicago Department of Public Health during the conduct of the study and grants from Third Coast Center for AIDS Research outside of the submitted work. Dr Pitrak reports grants from Gilead Sciences as part of the FOCUS Program. No other disclosures were reported.
                Funding/Support: This work was supported by the Chicago Department of Public Health and the Gilead Sciences FOCUS Program.
                Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
                Additional Contributions: We thank the following individuals who were key to program implementation, data collection and management, and clinical care: Eleanor Friedman, PhD, Aniruddha Hazra, MD, Michelle Moore, RN, APN, and Michelle Taylor, LCSW, of the Section of Infectious Diseases and Global Health at The University of Chicago Medicine. We also thank our Expanded HIV Testing and Linkage to Care collaborating sites: Beloved Community Family Wellness Center, Chicago Family Health Center, Community Health, Friend Family Health Center, Howard Brown Health, Lawndale Christian Health Center, Mercy Medical Center, Rush University Medical Center, Sinai Health System, TCA Health Inc, and the University of Illinois at Chicago. No additional compensation was provided for these contributions.
                Article
                Publisher ID: ild210011
                DOI: 10.1001/jamainternmed.2021.0839
                PMC ID: 8042563
                PubMed ID: 33843944
                SO-VID: 15542460-6cfb-453e-b9bb-ba4f8ad45906
                Copyright © Copyright 2021 Stanford KA et al. JAMA Internal Medicine.
                License:

                This is an open access article distributed under the terms of the CC-BY-NC-ND License.

                History
                Date received : 15 December 2020
                Date accepted : 11 February 2021
                Categories
                Subject: Research
                Subject: Letters
                Subject: Research Letter
                Subject: Online First

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