1. Janet Lin, MD, MPH, Sweta Basnet, MS, Sara Baghikar, MD, Cammeo Mauntel-Medici, MPH, Sara Heinert, MPH University of Illinois at Chicago, College of Medicine, Chicago, Illinois The Centers for Disease Control and Prevention (CDC) recommend routine HIV screening in all healthcare settings for every person between the ages of 13 – 64 regardless of risk. 1 However, few emergency departments (EDs) across the US have applied this recommendation. 2 ED providers report inadequate time and resources as well as follow-up concerns for positive patients as barriers to routine HIV screening. 3 This research aims to: Determine if there is a relationship between knowledge and attitudes of providers regarding HIV testing and self-reported current testing practices in an urban academic hospital. Understand provider behavior and attitudes prior to implementation of a routine opt-out HIV screening program. Identify barriers to HIV testing in the ED in order to inform the design and workflow of a routine opt- out HIV screening program. There was no association between HIV testing practices and HIV knowledge, attitudes, or perceived barriers to testing. Provider testing practices were significantly associated with perceived testing practices of colleagues, and the majority of providers reported very low numbers of HIV tests ordered. This suggests a need for a culture change around HIV screening in the ED. Perceived barriers regarding time constraints, burdensome consent process, and linkage to care indicate a need for a structured HIV screening program that is well-integrated within the ED workflow. Without the support and structure of an HIV testing program, ED providers are not likely to perform routine HIV screening per CDC recommendations. Provider knowledge gaps may also impede uptake of routine HIV screening programs, and could be overcome by increased provider education. ConclusionsResults Prior to implementing routine HIV screening in the ED of University of Illinois Hospital, Chicago, a 24-item questionnaire was administered to a convenience sample of 174 providers who attended mandatory provider training sessions in Fall 2014. The survey evaluated HIV testing practices, perceived barriers to HIV testing, knowledge of HIV epidemiology and screening recommendations, and attitudes toward a routine HIV screening program in the ED. Chi-square tests were used to examine associations between responses. Data was analyzed using SAS Software Version 9.4 (SAS Institute Inc., Cary, NC, USA). Methods Introduction 1. Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report, Revised Recommendations for HIV testing of adults, adolescents and pregnant women in healthcare settings. MMWR Recommendations and Reports 2006; 55:1-17. 2. Arbelaez, C., Wright, A.E, Losina, E., et al. Emergency Provider Attitudes and Barriers to Universal HIV Testing in the ED. Journal of Emergency Medicine 2012; 42(1): 7-14. 3. Haukoos, J.S., Hopkins, E., Hull, A., et al. HIV testing in emergency departments in the United States: a national survey. Annals of Emergency Medicine 2011; 58(1): S10-6. Sources Project HEAL is supported by FOCUS, a program of GILEAD Sciences, Inc. and by a grant from the Chicago Department of Public Health FP-57439. Acknowledgements Self-reported frequency of HIV testing in comparison to colleagues (N=136) (p<0.01) Number of tests ordered in the past six months n(%) 01 – 56 – 20> 20 Total3777166 More frequently3 (8.1)3 (3.9)1 (6.3)3 (50.0) Same frequency27 (73.0)60 (77.9)14 (87.5)2 (33.3) Much less frequently7 (18.9)14 (18.2)1 (6.3)1 (16.7) Emergency Department Provider Knowledge and Attitudes on HIV Screening and Potential Impact on Uptake of a Routine HIV Screening Program Association Between Number of Tests Ordered by Providers & Perceived Testing Practices of Colleagues 84% of providers reported ordering ≤5 HIV tests in the past 6 months. Among those providers, over 70% felt their testing practices were on par with those of their colleagues. Barriers to HIV Testing in the ED Knowledge  66.3% of respondents were not aware of the HIV prevalence in the hospital’s zip-code area  61.5% did not know if HIV testing is covered by insurance as an annual preventive health screening Attitudes  44.3% of respondents believed that all patients should be offered HIV testing  34.5% and 42.5% said they would rarely or only occasionally offer an HIV test to patients in the absence of an HIV testing program, respectively Reasons for Not Offering an HIV test Distribution of Survey Respondents by Provider Type (N = 174).