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Publication Profiles

Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment

Citation

Bradford W, Akselrod H, Bassler J, et al. Hospitalization is a missed opportunity for HIV screening, pre-exposure prophylaxis, and treatment. Addict Sci Clin Pract. 2024;19(1):22. doi:10.1186/s13722-024-00451-z

Implementation stage:

Pre-Implementation

Implementation outcomes reported:

Not applicable

Continuum target addressed:

HIV testing, Linkage to HIV care, ART initiation ,Viral suppression ,PrEP initation

Geography:

Non-priority jurisdiction

Study Participant Classification:

Recipients of care

Plain Language Objectives

The researchers wanted to determine whether hospitalization was being used to provide HIV testing, HIV-prevention medicine, and connection to treatment for people with opioid use disorder who had infections related to injecting drugs.

Plain Language Abstract

Hospitalization may provide an opportunity to offer HIV prevention and treatment to people who inject drugs, but these services are often missing from inpatient care. The researchers reviewed records from 322 patients with opioid use disorder who were hospitalized during 2018 at multiple medical centers for infections related to injection drug use. Among 300 patients without known HIV, only two had a documented discussion of pre-exposure prophylaxis, or PrEP, and only one received a PrEP prescription at discharge. Among 22 patients living with HIV, 13 (59%) had a viral-load test during admission; all 13 had detectable HIV in their blood. Ten of the 22 patients (45%) were successfully connected with HIV care after discharge. Both groups also had high levels of hospital readmission, unstable housing, and Medicaid coverage or no insurance. The findings show substantial missed opportunities to provide HIV testing, prevention, and treatment during hospitalization. The authors recommended more comprehensive, status-neutral services, meaning that patients receive appropriate prevention or treatment regardless of HIV status. This retrospective record review describes care delivered and does not test a new hospital program.

Key Takeaways

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