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Analysis of HIV Testing Acceptance and Risk Factors of an Adolescent Cohort Using Emergency Department–Based Multimedia HIV Testing and Counseling

Calderon, Yvette MD, MS*†; Chou, Katherine MD*†; Cowan, Ethan MD, MS*†; Rhee, John Y. BS*; Mathew, Sheba MD*; Ghosh, Reena MD; Fettig, Jade MS*; Nickerson, Jillian BS*; Leider, Jason MD, PhD*†

doi: 10.1097/01.OLQ.0000430800.07217.01
Original Study

Background The social environment in the Bronx, NY, has led to HIV infection rates among young people that are much higher than the national average.

Methods A prospective observational study on a convenience sample of medically stable emergency department (ED) patients was conducted from October 1, 2005, to August 31, 2012. Acceptability of the tested model was determined by assessing the number of patients tested and identified HIV infections. Data were compared with data from the rest of the ED that tested for HIV.

Results A total of 10,149 adolescents were approached during this period, of which 9.5% refused or were ineligible to test. Of those approached, 38.9% of patients were male, 59.7% were Hispanic, and 33.6% were black. The mean age was 19.4 ± 1.4 years, and 8.2% of patients were men who have sex with men. For risk behavior profiles, 24.3% never used condoms in the past 3 months. Incidence of HIV was less than 1%, and 92.6% of HIV-positive patients were linked to care. Of the patients who completed a postsatisfaction survey, 82.4% felt influenced to change their sexual practices.

A smaller percentage of adolescent had tested previously for HIV compared with nonadolescents (67.7% vs. 80.6%). There was a slightly larger percentage of adolescents that accepted HIV testing compared with nonadolescents (95.4% vs. 90.8%). Adolescents who were positive for HIV were tested earlier in the progression of the disease, with higher median CD4 cell counts and lower viral loads compared with nonadolescents.

Conclusions Adolescents were highly receptive to a multimedia-integrated ED-based HIV testing program, as indicated by their high uptake of testing.

This study aimed to evaluate risk factor behavior and determine the receptiveness of adolescents (age, 13–21 years) toward an emergency department rapid oral HIV testing program using integrated video counseling and computer-assisted data collection.

From the *Jacobi Medical Center, Bronx, NY, and †Albert Einstein College of Medicine, Bronx, NY

Conflicts of interest and source of funding: Funding for this study was provided by the Public Health Solutions of New York City, Inc/HIV Care Services Contract No. 07-RTX-583 for HIV Rapid Testing in Clinical Facilities. There is no conflict of interest for any of the listed authors.

Correspondence: Yvette Calderon, MD, MS, Jacobi Medical Center, 1400 Pelham Parkway South, Building 6, Room 1B27, Bronx, NY 10461. E-mail:

Received for publication November 15, 2012, and accepted April 30, 2013.

© Copyright 2013 American Sexually Transmitted Diseases Association