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Implementation of Nurse-Initiated Rapid HIV Testing at High-Prevalence Primary Care Sites Within the US Veterans Affairs Health Care System

Anaya, Henry D. PhD*†‡; Butler, Jaimi N. MA*; Solomon, Jeffrey L. PhD§; Knapp, Herschel PhD, MSSW*; Hoang, Tuyen PhD*; Kan, Virginia MD∥¶; Rodriguez-Barradas, Maria C. MD#**; Hare, Katherine A. BS; Kertz, Barbara MS#; Bokhour, Barbara PhD§

Sexually Transmitted Diseases: April 2013 - Volume 40 - Issue 4 - p 341–345
doi: 10.1097/OLQ.0b013e31828417a5
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Nurse-initiated HIV rapid testing (NRT) increases testing/receipt of results compared with traditional testing. We implemented NRT in primary care clinics at 2 Veterans Affairs hospitals.

At site 1, 2364 tests were conducted; 5 HIV positives were identified. At site 2, 2522 tests were conducted; 9 HIV positives were identified. Success varied across demographic/clinical strata.

A nurse-initiated HIV rapid testing effort was conducted at 2 Veterans Affairs medical centers. Testing increased significantly compared with the preintervention period. Fourteen previously undetected HIV positives were identified at both sites.

From the *Veterans Affairs (VA) Quality Enhancement Research Initiative for HIV and Hepatitis (QUERI-HIV/HEP) and Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Health Services Research and Development Center of Excellence, VA Greater Los Angeles Healthcare System, Los Angeles CA; †Division of General Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA; ‡VA Center for the Management of Complex Chronic Conditions and the Quality Enhancement Research Initiative for Spinal Cord Injury (SCI), VA Chicago Healthcare System, Chicago, IL §VA New England Healthcare System, Bedford, MA; ∥VA Medical Center, Washington, DC; ¶Infectious Diseases Section, The George Washington University, Washington, DC; #Infectious Disease Section, Michael E. DeBakey VA Medical Center, Houston, TX; and **Department of Medicine, Baylor College of Medicine, Houston, TX

This research was funded by VA Quality Enhancement Research Initiative (QUERI) grant SDP 07-318 awarded to the first author and supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. The authors thank the primary care clinics and all the nurses who participated in these testing efforts; their participation, dedication, support, and patience were invaluable. The views and opinions expressed in this article are those of the authors and do not necessarily represent the views of the US Department of Veterans Affairs. The Veterans Health Administration supported this study but had no input in the design or reporting, or decision to submit this manuscript for publication. This study was reviewed and sanctioned by a US Department of Veterans Affairs institutional review board process.

Conflict of interest statement: The first author owns stock in a company that produces biotechnological biomarker tests, one of which is an HIV rapid test. All other authors have no conflict of interest. For the remaining authors, none was declared.

All authors have given a substantial contribution to conception and design, or acquisition of data, or analysis and interpretation of data; assisted in drafting the article or revising it critically for important intellectual content; and given final approval of the version to be published.

Correspondence: Henry D. Anaya, PhD, 11301 Wilshire Blvd 111G, Los Angeles, CA 90073. E-mail:

Received for publication August 27, 2012, and accepted December 18, 2012.

© Copyright 2013 American Sexually Transmitted Diseases Association