1. A&E HIV Testing Pilot St George’s Hospital David Cox

2. Aim To offer an HIV test to all men and women between the ages of 18 –65 attending St George’s A&E in addition to routine blood tests already being taken To offer an HIV test to all men and women between the ages of 18 –65 attending St George’s A&E in addition to routine blood tests already being taken To improve the detection rate of HIV To improve the detection rate of HIV To assess acceptability of HIV testing to patients and staff within the ED setting To assess acceptability of HIV testing to patients and staff within the ED setting

3. Training Health Adviser led / Consultant supported Health Adviser led / Consultant supported 2 hour training programme 2 hour training programme Small groups max 10 Small groups max 10 On-site On-site Lead A&E staff identified Lead A&E staff identified

4. Eligibility Adults aged between18-65 Adults aged between18-65 Attending A&E between 1 st -31 st March 2011 Attending A&E between 1 st -31 st March 2011 Care pathway included venepuncture Care pathway included venepuncture All patients unable to consent were excluded All patients unable to consent were excluded

5. Methods Consent obtained to take an HIV test in addition to other blood tests Consent obtained to take an HIV test in addition to other blood tests Patient given an information leaflet Patient given an information leaflet The patient’s A&E notes stamped, indicating whether offered and accepted test The patient’s A&E notes stamped, indicating whether offered and accepted test Weekly telephone results line Weekly telephone results line Reactive results reported to health adviser team Reactive results reported to health adviser team

6. Results 2726 majors and resus patients had blood tests 1 st - 31st of March 2726 majors and resus patients had blood tests 1 st - 31st of March 584 HIV tests (21.4%) 584 HIV tests (21.4%) 3 new cases identified (incidence 0.5%) 3 new cases identified (incidence 0.5%) Additionally 7 known HIV positive patients attended A&E during this period Additionally 7 known HIV positive patients attended A&E during this period

7. Discussion Areas for improvement Areas for improvement Incomplete data collection affecting analysis Incomplete data collection affecting analysis Large numbers of staff in A&E resulted in difficulty in obtain engagement and consistent data collection Large numbers of staff in A&E resulted in difficulty in obtain engagement and consistent data collection

8. Would having a dedicated health adviser improve uptake of HIV testing and quality of data collection?