• Cameron T Miller, Kristin S Alvarez, Ank E Nijhawan, Virali Soni, Lena Turknett, Raja Paspula, and Helen L King.
• From the University of Texas Southwestern Medical Center, Dallas, Texas (CTM); Parkland Health, Center of Innovation and Value, Dallas, Texas (KSA); University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, Dallas, Texas (AEN); Parkland Health, Center of Innovation and Value, Dallas, Texas (VS); Parkland Health, HIV Services, Dallas, Texas (LT); Medical Director COPC, Parkland Health, Dallas, Texas (RP); University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Infectious Diseases and Geographic Medicine, Dallas, Texas (HLK).
• J Am Board Fam Med. 2024 Oct 25; 37 (4): 650659650-659.

BackgroundScreening rates for Human Immunodeficiency Virus (HIV) remain low despite guidelines by both the CDC and USPSTF recommending that all adolescents and adults be screened at least once. The aim of this quality improvement study was to increase HIV screening among eligible patients.MethodsThis quality improvement study assessed the impact of interventions to increase HIV screening in an outpatient population at a large urban safety-net hospital. Outcomes were compared from the preintervention (December 2020 to November 2021) to postintervention years (December 2021 to November 2022). Stepwise electronic alerts to prompt HIV screening paired with provider financial incentives were implemented. The proportion of eligible individuals screened for HIV were compared after intervention implementation.ResultsAverage monthly HIV screening increased from 506 ± 97 to 2484 ± 663 between the pre- and postintervention periods, correlating to a 5.1-fold increase in screening (7.8% to 39.8%, P < .01). Increases were seen across all ages, and those aged 55 to 64 and 65+ had the highest relative increase in screening at 7.5 and 9.3-fold, respectively (P < .01). Screening rates increased for Hispanics (7.9% preintervention vs 43.6% postintervention, P < .01). In the pre- and postintervention periods, 41 patients with new HIV diagnoses were identified (13 preintervention and 28 postintervention) and 85.4% were linked to care within 30 days.ConclusionsStepwise interventions targeted at primary care clinicians are an effective way to increase HIV screening rates, particularly in older demographics. Earlier HIV diagnosis coupled with linkage to care is an important strategy in ending the HIV epidemic.© Copyright 2024 by the American Board of Family Medicine.

30 keywords...

hide…