(P151) STI SCREENING IN EMERGENCY DEPARTMENTS: ASSESSING LINKAGE TO HIV PREVENTION SERVICES PROGRAM

Background:
The Centers for Disease Control and Prevention (CDC) recommends that Emergency Departments (EDs) offer routine opt out HIV screening. St. Joseph’s Medical Center (SJMC) implemented routine HIV/HCV and Syphilis screening within the hospital’s ED. Cases of patients who had previously tested HIV negative at SJMC’s ED but were subsequently diagnosed HIV positive were observed. A workflow to identify patients at high risk for HIV and link them to prevention services was implemented in response.

Methods:
From April 2022 – December 2023, ED medical providers offered routine opt-out HIV and syphilis testing for patients 13 years of age or older, who were having blood drawn. Fourth generation laboratory testing procedures were implemented for HIV screening and the reverse algorithm implemented for syphilis testing. Patients receiving a negative HIV result and a positive syphilis result were offered linkage to HIV prevention services.

Results:
A total of 34,692 patients were screened for HIV and 48,933 were screened for Syphilis. Of those screened, 999 patients had a positive syphilis result and a negative HIV result. Among the 999 patients, 50.2% were male, 49.5% female and 0.3% identified as other gender. The racial breakdown included 27.2% Black/African American, 38.0% White/Caucasian, 21.4% Bi-racial/Multi-racial, 10.1% Asian, 0.7% American Indian/Alaska Native, 0.2% Native Hawaiian/Pacific Islander and 2.3% not reported. Of those patients 109 were linked to HIV prevention services, and at minimum assessed by an outpatient clinician for PrEP. Some barriers to linking patients to care/patients beginning PrEP were: lack of accurate contact information for follow-up, costs, housing, side effects, and stigma.

Conclusion:
The enhanced workflow offered via SJMC’s ED identified patients at high risk for HIV transmission and linked them to PrEP. Further research is needed to comprehensively evaluate the possible HIV positive cases adverted by implementing a linkage to HIV prevention services program in the ED.