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

• Published in: American journal of public health (1971) Vol. 97; no. 12; pp. 2173 - 2178
• Main Authors: Owens, Douglas K, Sundaram, Vandana, Lazzeroni, Laura C, Douglass, Lena R, Sanders, Gillian D, Taylor, Kathie, VanGroningen, Ronald, Shadle, Vera M, McWhorter, Valerie C, Agoncillo, Teodora, Haren, Noreen, Nyland, Jill, Tempio, Patricia, Khayr, Walid, Dietzen, Dennis J, Jensen, Peter, Simberkoff, Michael S, Bozzette, Samuel A, Holodniy, Mark
• Format: Journal Article
• Language: English
• Published: Washington, DC Am Public Health Assoc 01.12.2007; American Public Health Association
• Subjects: Acquired immune deficiency syndrome; Adult; Age groups; Aged; AIDS; Alzheimer's disease; Biological and medical sciences; Comorbidity; Confidence intervals; Cost-Benefit Analysis; Data collection; Disease control; Enzymes; Estimates; Ethnicity; Health care; Hepatitis; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV Seroprevalence; Hospitals; Human immunodeficiency virus; Human viral diseases; Humans; Immunoassay; Infections; Infectious diseases; Mass Screening - economics; Medical records; Medical sciences; Medical screening; Medical tests; Middle Aged; Miscellaneous; Multivariate Analysis; Patients; Pneumonia; Prevention and actions; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Research and Practice; Sample size; Serology; Studies; United States - epidemiology; United States Department of Veterans Affairs - statistics & numerical data; Urban areas; Veterans; Veterans - statistics & numerical data; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; United States; North America; America; Human; Health system; Immunopathology; Health insurance; Prevalence; Retroviridae; Patient; AIDS; Medical screening; Immune deficiency; Lentivirus; Care; Infection; Virus; Viral disease; Ambulatory; Hospital; Human immunodeficiency virus; Veteran; Public health
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2007.110700

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