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Many Unaware of HIV Status Until It's Advanced

ER study also finds high proportion without health insurance

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

THURSDAY, June 26, 2014 (HealthDay News) -- Few patients treated at U.S. emergency departments have HIV, but those who do test positive for the virus are in the most infectious stage or have already developed AIDS, a new study says.

"People may believe that HIV and AIDS are diseases of the 20th century, but our results show that many people continue to be infected without being aware of it," said study author Dr. Kara Iskyan Geren, of Maricopa Integrated Health System in Phoenix.

Researchers looked at data from nearly 22,500 ER patients who were tested for HIV. Of those, only 0.28 percent of patients were found to have the AIDS-causing virus.

Of those who tested positive, 23 percent had acute HIV infections (most infectious stage) and 28 percent had progressed to AIDS, according to the study published online June 23 in the Annals of Emergency Medicine.

The researchers also found that 82 percent of ER patients with confirmed HIV did not have health insurance.

"Proper diagnosis before HIV progresses to AIDS allows for interventions that can extend life as well as minimize the risk of transmission to other people," Geren said in a journal news release. "Of the patients with confirmed HIV diagnosis, we were able to connect 72 percent with HIV care within 90 days."

The researchers used a relatively new test (available since 2009) that enables earlier and easier detection of HIV.

"In 2006, the Centers for Disease Control and Prevention suggested universal screenings for patients in populations with a prevalence of undiagnosed infections greater than 0.1 percent, which would include our patient population," Geren said.

"However, it is difficult to ask an already overburdened, underfunded emergency department and its staff to perform a public health function," she added.

"The reality is that the lack of organizational support and upfront costs will likely be a major barrier to implementing this type of testing in many emergency departments across the country," she concluded.

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