Unknown HIV Status in the Emergency Department

Abstract

Objectives: The authors sought to determine the prevalence of unknown HIV status among emergency department (ED) patients, how it has changed over time, and whether it differs according to patient characteristics. Methods: The authors used electronic medical record data to identify whether HIV status was known or unknown among patients aged ≥13 seen in the ED of a large, urban medical center between 2006 and 2011. The authors used multivariate logistic regression to identify the characteristics associated with unknown HIV status. Results: The prevalence of unknown HIV status decreased each year, from 87.7% in 2006 to 74.9% in 2011 ( P < .001). Characteristics associated with unknown HIV status included being nonblack, in the youngest and oldest age-groups, and nonpublically insured. Compared to men, women without prior pregnancy were equally likely to have unknown HIV status, but women with prior pregnancy were significantly less likely to have unknown HIV status. Conclusion: The prevalence of unknown HIV status is decreasing, but in 2011 75% of ED patients aged ≥13 still had unknown status, and it was associated with specific patient characteristics. Understanding the trends in the prevalence of unknown HIV status and how it is associated with patient characteristics should inform the design and implementation of expanded HIV-testing strategies.