Prevalence of People With HIV Visiting the Emergency Department and Linkage to Care Status
Recommended Citation
Patel M, Bender D, Zahul S, Payne S, Hagerman T, Rammal JK, Klausner H, Miller JB, Brar I, Manteuffel J. Prevalence of People With HIV Visiting the Emergency Department and Linkage to Care Status. Ann Emerg Med 2024; 84(4):S104.
Document Type
Conference Proceeding
Publication Date
10-1-2024
Publication Title
Ann Emerg Med
Abstract
Study Objectives: Emergency department (ED) screening for HIV is part of a larger effort to end the HIV epidemic. Identifying new cases of HIV and linking them to care is crucial, however, equally important is the effort to ensure people with HIV (PWH) not in care are linked to care. Due to complicating social determinants of health, the ED is potentially an important setting for re-linking PWH to care. In this pilot study, we intend to determine the number of PWH visiting the ED and their linkage to care status. We hypothesize a substantial number of PWH visiting the ED are not linked to care and present an opportunity to be re-linked to care as part of a larger public health intervention to end the HIV epidemic. Methods: To identify PWH visiting the ED we performed a retrospective chart review of ED visits at a single urban tertiary care hospital from November 2023 through March 2024. For all ED visits, the electronic medical record (EMR) was queried, and patients were included if there was a previous diagnosis of HIV in the past medical history, problem list, or if a previous positive lab value for HIV-1 antibody was present. Patients were determined to be linked to care if they had a clinic visit or HIV related lab values in the past year, if not, then they were determined to be not in care. Records were reviewed using the local EMR, Care Everywhere and by consulting with the Michigan Department of Health and Human Services. For patients with repeat visits, their first ED visit became the index visit for retrospective review. Patient demographics and HIV viral loads were recorded. Results: During the review period, 305 unique PWH visited the ED for a total of 577 encounters and of these patients, 238 (78%) patients were linked to care of which 67 patients (22%) were not in care. The majority of patients were male (76.1%) and Black (86.6%). Of the 133 patients linked to care within our health system, 19 (14.3%) had HIV viral loads (VL) > 200 copies/mL. Of the 67 patients not in care, 8 had no previous record for VL, 5 had undetected VL, and another 5 had VL < 30 copies/mL. Of the remaining 49 patients, the average viral load was 106,396.8 copies/mL. Conclusion: Ending the HIV epidemic will take efforts from multiple stakeholders, including ED HIV screening programs. The prevalence of PWH presenting to EDs is not well described in the literature. Our results suggest the ED may be an important setting and opportunity to reconnect PWH to care. These efforts could be a natural adjunct to ED based HIV screening programs.
Volume
84
Issue
4
First Page
S104
