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- Title
Opt-out screening strategy for HIV infection among patients attending emergency departments: systematic review and meta-analysis.
- Authors
Henriquez‐Camacho, C; Villafuerte‐Gutierrez, P; Pérez‐Molina, JA; Losa, J; Gotuzzo, E; Cheyne, N
- Abstract
Objectives International health agencies have promoted nontargeted universal (opt-out) HIV screening tests in different settings, including emergency departments ( EDs). We performed a systematic review and meta-analysis to assess the testing uptake of strategies (opt-in targeted, opt-in nontargeted and opt-out) to detect new cases of HIV infection in EDs. Methods We searched the Pubmed and Embase databases, from 1984 to April 2015, for opt-in and opt-out HIV diagnostic strategies used in EDs. Randomized controlled or quasi experimental studies were included. We assessed the percentage of positive individuals tested for HIV infection in each programme (opt-in and opt-out strategies). The mean percentage was estimated by combining studies in a random-effect meta-analysis. The percentages of individuals tested in the programmes were compared in a random-effect meta-regression model. Data were analysed using stata version 12. Quality assessments were performed using the Newcastle−Ottawa Scale. Results Of the 90 papers identified, 28 were eligible for inclusion. Eight trials used opt-out, 18 trials used opt-in, and two trials used both to detect new cases of HIV infection. The test was accepted and taken by 75 155 of 172 237 patients (44%) in the opt-out strategy, and 73 581 of 382 992 patients (19%) in the opt-in strategy. The prevalence of HIV infection detected by the opt-out strategy was 0.40% (373 cases), that detected by the opt-in nontargeted strategy was 0.52% (419 cases), and that detected by the opt-in targeted strategy was 1.06% (52 cases). Conclusions In this meta-analysis, the testing uptake of the opt-out strategy was not different from that of the opt-in strategy to detect new cases of HIV infection in EDs.
- Subjects
DIAGNOSIS of HIV infections; PSYCHOLOGY of HIV-positive persons; HOSPITAL emergency services; MEDICAL information storage &; retrieval systems; MEDICAL screening; MEDLINE; META-analysis; ONLINE information services; SYSTEMATIC reviews; DESCRIPTIVE statistics
- Publication
HIV Medicine, 2017, Vol 18, Issue 6, p419
- ISSN
1464-2662
- Publication type
Article
- DOI
10.1111/hiv.12474