(PL19) STANDARDIZING OPT-OUT HIV AND SYPHILIS SCREENING PROCESS IN THE EMERGENCY DEPARTMENT FOR PATIENTS’S AGES 13 YEARS AND OLDER

Background:
The amount of persons with HIV and/or syphilis to be missed due to no implementation of standardized screening in the ED is unbelievable. The objective was to standardize an opt-out HIV and syphilis screening process in the Emergency department for patients’ ages 13 years and older to identify positive persons and provide linkages to care.

Methods:
This is a descriptive analysis of the first year (2023 May - 2024 April) integrating an opt-out HIV and syphilis screening and providing linkages for identified positives for ages 13 and older. This project used best practices advisory from CDPH and CDC to standardized HIV and syphilis screenings in the ED prompting CBC orders to commence automatic screenings and to provide an effective navigation system to link identified positive patients to care. Outcomes included volume of tests performed, HIV and syphilis positivity rates, and linkages.

Results:
10,123 patients were screened for HIV in the ED from the project’s first year launch. (13) 0.13% screened patients were newly identified with HIV+. (13) 100% newly HIV+ were successfully linked to care. (303) 3% screened patients were identified with an active syphilis RPR titer. The patient navigator was able to link appointments to (154) 51% of those identified with syphilis. Of those identified syphilis, (141) 92% attended their appointments. Demographics, screening rates, linkage barriers, and treatment rates vary between patients based on sociodemographic characteristics.

Conclusion:
We concluded that standardizing an opt-out HIV and syphilis screening in the Emergency department for patients’ ages 13 years and older helps identify missed positive persons and effectively link them to care. Differences of diagnoses and linkage to care varies on persons’ sociodemographic characteristics. With this project, we were able to screen a significant amount, identify the positivity rates, and improve the navigation system workflow.