The Prevalence of Undiagnosed HIV Infection in Those Who Decline HIV Screening in an Urban Emergency Department
2011

HIV Infection Rates in Patients Who Decline Testing

Sample size: 600 publication Evidence: high

Author Information

Author(s): M. Czarnogorski, J. Brown, V. Lee, J. Oben, I. Kuo, R. Stern, G. Simon

Primary Institution: The George Washington University

Hypothesis

Patients underestimate their HIV risks, and the rate of undetected HIV in patients who decline testing would be as high as the rate in those who accept the test.

Conclusion

The rate of occult HIV infection is nearly three-times higher in those who decline routine ED HIV testing compared with those who accept such testing.

Supporting Evidence

  • 12 out of 600 patients who declined testing were reactive for HIV.
  • The positivity rate for those who accepted testing was only 0.7%.
  • The relative risk of undetected HIV infection in those who declined testing was 2.74 times higher.

Takeaway

People who say they don't want an HIV test might actually have a higher chance of being infected than they think.

Methodology

Discarded blood samples from patients who declined routine HIV testing were screened for HIV using rapid testing.

Potential Biases

Social desirability bias may have influenced patients' reasons for declining testing.

Limitations

The study may not account for patients who were aware of their HIV status but declined testing.

Participant Demographics

Patients aged 18-64, with no known HIV positive status, from an urban emergency department.

Statistical Information

P-Value

0.001

Confidence Interval

95% CI 1.44–5.18

Statistical Significance

p = .001

Digital Object Identifier (DOI)

10.1155/2011/879065

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