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AJPH First Look, published online ahead of print Oct 30, 2007
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American Journal of Public Health, 10.2105/AJPH.2007.110700

Research and Practice

Prevalence of HIV Infection Among Inpatients and Outpatients in Department of Veterans Affairs Health Care Systems: Implications for Screening Programs for HIV

Douglas K. Owens 1*, Vandana Sundaram 1, Laura C. Lazzeroni 2, Lena R. Douglass 3, Gillian D. Sanders 4, Kathie Taylor 3, Ronald VanGroningen 3, Vera M. Shadle 5, Valerie C. McWhorter 6, Teodora Agoncillo 6, Noreen Haren 7, Jill Nyland 8, Patricia Tempio 3, Walid Khayr 8, Dennis J. Dietzen 9, Peter Jensen 5, Michael S. Simberkoff 7, Samuel A. Bozzette 6, Mark Holodniy 1

1 VA Palo Alto Healthcare System; Stanford University
2 Stanford University
3 VA Palo Alto Healthcare System
4 Duke University; Stanford University
5 VA San Francisco Healthcare System
6 VA San Diego Healthcare System
7 VA New York Harbor Healthcare System
8 VA North Chicago Healthcare System
9 VA Memphis Healthcare System

* To whom correspondence should be addressed. E-mail: owens{at}stanford.edu.


  Abstract

Objectives. We sought to determine the prevalence of HIV in both inpatient and outpatient settings in 6 Department of Veterans Affairs (VA) health care sites.

Methods. We collected demographic data and data on comorbid conditions and then conducted blinded, anonymous HIV testing. We conducted a multivariate analysis to determine predictors of HIV infection.

Results. We tested 4500 outpatient blood specimens and 4205 inpatient blood specimens; 326 (3.7%) patients tested positive for HIV. Inpatient HIV prevalence ranged from 1.2% to 6.9%; outpatient HIV prevalence ranged from 0.9% to 8.9%. Having a history of hepatitis B or C infection, a sexually transmitted disease, or pneumonia also predicted HIV infection. The prevalence of previously undocumented HIV infection varied from 0.1% to 2.8% among outpatients and from 0.0% to 1.7% among inpatients.

Conclusions. The prevalence of undocumented HIV infection was sufficiently high for routine voluntary screening to be cost effective in each of the 6 sites we evaluated. Many VA health care systems should consider expanded routine voluntary HIV screening.

Key Words: HIV/AIDS, Prevention, Screening




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Home page
 ANN INTERN MEDHome page
G. D. Sanders, A. M. Bayoumi, M. Holodniy, and D. K. Owens
Cost-Effectiveness of HIV Screening in Patients Older than 55 Years of Age
Ann Intern Med, June 17, 2008; 148(12): 889 - 903.
[Abstract] [Full Text] [PDF]


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