To identify missed opportunities (MO) and missed testing opportunities (MTO) for earlier HIV diagnosis in a safety-net healthcare system using routine opt-out testing, emphasizing their definitions.
Key Findings:
70% of newly diagnosed individuals had missed opportunities for testing in the prior year.
67% of encounters were classified as missed testing opportunities.
Sexual health-related encounters and STI testing had lower odds of missed opportunities (aOR 0.62; 95% CI, 0.42–0.90; P = .013).
Higher odds of CD4 < 350 cells/mm3 at diagnosis were associated with missed opportunities (aOR 1.8; 95% CI, 1.2–2.9; P = .011).
Interpretation:
Despite routine opt-out testing, a significant number of individuals diagnosed with HIV had not been tested in the previous year, indicating a need for improved testing procedures, particularly in primary care settings, to enhance early diagnosis.
Limitations:
Study limited to a single healthcare system, which may affect generalizability and applicability to other settings.
Potential confounding factors related to healthcare access and overutilization were not fully addressed, which may skew results.
Conclusion:
Optimizing opt-out testing procedures is crucial to enhance early HIV diagnosis and reduce transmission, particularly in primary care and nonsexual health visits, to ensure comprehensive testing coverage.
by Sarah F Gruber, Megan Schwinne, Rishika Iytha, Emma J Hollenberg, Chad Robichaux, Valeria D Cantos, Jonathan A Colasanti, Anna Q Yaffee, Sara Turbow, Eric Leue, Andrés Camacho-González, Yun F Wang, Meredith H Lora
Chemsex at the pharmacy counter. Gut bacteria tracking helmet impacts. PMD predicting psychiatric illness bidirectionally. This week's research keeps landing in the same uncomfortable place: medicine is improvising.
