National HIV and HCV Screening Rates for Hospitalized People who Use Drugs Are Suboptimal and Heterogeneous Across 11 US Hospitals

Author:

Westgard Leo Knudsen1,Sato Taisuke1ORCID,Bradford William S2,Eaton Ellen F2,Pilcher Finlay3,Hale Andrew J34,Singh Devika34,Martin Marlene56,Appa Ayesha A6,Meyer Jaimie P78,Weimer Melissa B79,Barakat Lydia A7,Felsen Uriel R1011,Akiyama Matthew J1011,Ridgway Jessica P12,Grussing Emily D113,Thakarar Kinna13141516ORCID,White Amy14,Mutelayi John14,Krsak Martin17ORCID,Montague Brian T17,Nijhawan Ank18,Balakrishnan Harini18,Marks Laura R19,Wurcel Alysse G113

Affiliation:

1. Tufts Medical Center , Boston, Massachusetts , USA

2. University of Alabama at Birmingham , Birmingham, Alabama , USA

3. Larner College of Medicine, University of Vermont , Burlington, Vermont , USA

4. University of Vermont Medical Center , Burlington, Vermont , USA

5. Zuckerberg San Francisco General Hospital , San Francisco, California , USA

6. University of California , San Francisco, California , USA

7. Yale School of Medicine , New Haven, Connecticut , USA

8. Yale University School of Public Health , New Haven, Connecticut , USA

9. Yale New Haven Hospital , New Haven, Connecticut , USA

10. Montefiore Medical Center , Bronx, New York , USA

11. Albert Einstein College of Medicine , Bronx, New York , USA

12. University of Chicago , Chicago, Illinois , USA

13. Tufts University School of Medicine , Boston, Massachusetts , USA

14. Maine Medical Center Research Institute , Portland, Maine , USA

15. Maine Medical Center , Portland, Maine , USA

16. Maine Medical Partners Adult Infectious Diseases , South Portland, Maine , USA

17. University of Colorado School of Medicine , Denver, Colorado , USA

18. University of Texas Southwestern Medical Center , Dallas, Texas , USA

19. Washington University in St. Louis School of Medicine , St. Louis, Missouri , USA

Abstract

Abstract Background To end the HIV and hepatitis C virus (HCV) epidemics, people who use drugs (PWUD) need more opportunities for testing. While inpatient hospitalizations are an essential opportunity to test people who use drugs (PWUD) for HIV and HCV, there is limited research on rates of inpatient testing for HIV and HCV among PWUD. Methods Eleven hospital sites were included in the study. Each site created a cohort of inpatient encounters associated with injection drug use. From these cohorts, we collected data on HCV and HIV testing rates and HIV testing consent policies from 65 276 PWUD hospitalizations. Results Hospitals had average screening rates of 40% for HIV and 32% for HCV, with widespread heterogeneity in screening rates across facilities. State consent laws and opt-out testing policies were not associated with statistically significant differences in HIV screening rates. On average, hospitals that reflexed HCV viral load testing on HCV antibody testing did not have statistically significant differences in HCV viral load testing rates. We found suboptimal testing rates during inpatient encounters for PWUD. As treatment (HIV) and cure (HCV) are necessary to end these epidemics, we need to prioritize understanding and overcoming barriers to testing.

Funder

Einstein-Rockefeller-CUNY Center for AIDS Research

NIAID

NCI

NICHD

NHLBI

NIDA

NIMH

NIA

FIC

NIMHD

NIGMS

NIDDK

OAR

Publisher

Oxford University Press (OUP)

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