There have been many medical advancements in the fight to prevent and cure HIV/AIDS, but it still remains a serious social dilemma. Approximately 50,000 people are diagnosed with HIV/AIDS every year, and over 200,000 people are unaware they even have HIV/AIDS. This lack of awareness is a leading factor in the spread of HIV/AIDS every year. Despite the continued education about the illness, many people are fearful of the disease and avoid being tested because of the stigma that is still attached to HIV/AIDS. In recent years, the Centers for Disease Control and Prevention has spearheaded efforts to offer HIV testing to people in emergency rooms nationwide. This tactic has helped increase the number of identified cases, but many people who are offered such testing refuse or never complete it, hampering the overall goal of diagnosing those with HIV/AIDS in an attempt to reduce the spread of the illness.
Jeffrey Sankoff of the Department of Emergency Medicine at the Denver Health Medical Center in Colorado realized this and sought to determine which individuals were most likely to accept free rapid HIV testing and what factors prevented people from doing so. Sankoff analyzed data from 31,525 patients who were admitted to his emergency department (ED) over a 2-year period. He discovered that individuals with private insurance were least likely to accept the testing. Hispanic patients and Black patients, who made up 37% and 14% of the total patient pool, respectively, were the most likely to agree to the opt-out HIV test. Overall, only 23% of the individuals admitted to the ED during the 2-year period took the test.
Sankoff also discovered that the largest percentage of test-taking individuals came from the uninsured patient pool. Even though the number of uninsured Black patients was relatively equal to the number of uninsured White patients, more Black patients took the test than White patients. Another barrier to test taking was payment. The majority of individuals in the highest risk categories for HIV/AIDS had state or federally subsidized insurance or had no insurance at all. The high cost of HIV/AIDs testing could discourage these individuals from getting tested. Sankoff added, “Although efforts to improve payment for non-targeted HIV screening are ongoing, including improving commercial payment, additional efforts to fund HIV testing or focus scarce resources are required.”
Sankoff, J., Hopkins, E., Sasson, C., Al-Tayyib, A., Bender, B. (2012). Payer status, race/ethnicity, and acceptance of free routine opt-out rapid HIV screening among emergency department patients. American Journal of Public Health, 102.5, 877-883.
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