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Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital

BACKGROUND: Early diagnosis of human immunodeficiency virus (HIV) allows for appropriately timed interventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore’s Ministry of Health implemented HIV voluntary o...

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Autores principales: Tan, Xin Quan, Goh, Wei-Ping, Venkatachalam, Indumathi, Goh, Diana, Sridhar, Revathi, Chan, Hwang Ching, Archuleta, Sophia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303265/
https://www.ncbi.nlm.nih.gov/pubmed/25611741
http://dx.doi.org/10.1371/journal.pone.0116987
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author Tan, Xin Quan
Goh, Wei-Ping
Venkatachalam, Indumathi
Goh, Diana
Sridhar, Revathi
Chan, Hwang Ching
Archuleta, Sophia
author_facet Tan, Xin Quan
Goh, Wei-Ping
Venkatachalam, Indumathi
Goh, Diana
Sridhar, Revathi
Chan, Hwang Ching
Archuleta, Sophia
author_sort Tan, Xin Quan
collection PubMed
description BACKGROUND: Early diagnosis of human immunodeficiency virus (HIV) allows for appropriately timed interventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore’s Ministry of Health implemented HIV voluntary opt-out screening (VOS) for hospitalised adults. We evaluated the outcome of VOS and surveyed reasons for its low uptake in our institution. METHODS: We assessed the outcomes of the VOS programme from January 2010 to December 2013 at National University Hospital, a 1081-bed tertiary hospital in Singapore. We also examined reasons for opting-in and opting-out using an interviewer–administered structured questionnaire in a representative sample in January 2013. RESULTS: 107,523 patients fulfilled VOS criteria and were offered HIV screening, of which 5215 (4.9%) agreed to testing. 4850 (93.1%) of those who opted-in had an HIV test done. Three (0.06%) tested positive for HIV. 238 patients (14.2%) were surveyed regarding reasons for opting-in or out of VOS. 21 (8.8%) had opted-in. Patients who opted-in were likely to be younger, more educated and reported having more regular sexual partners. Type of housing, number of casual sexual partners, sexual orientation, intravenous drug use, condom use and previous sexually transmitted infection were not associated with deciding to opt-in/out. Patients’ most common reasons for opting-out were: belief that they were at low risk (50.2%), belief that they were too old (26.8%), cost (6.9%) and aversion to venepuncture (6.5%). The most common reason for opting-in was desire to know their HIV status (47.6%). CONCLUSION: The success of an HIV-VOS program is largely determined by test uptake. Our study showed that the majority of eligible VOS patients opted-out of HIV screening. Given the considerable cost and low yield of this programme, more needs to be done to better equip patients in self-risk assessment and opting in to testing.
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spelling pubmed-43032652015-01-30 Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital Tan, Xin Quan Goh, Wei-Ping Venkatachalam, Indumathi Goh, Diana Sridhar, Revathi Chan, Hwang Ching Archuleta, Sophia PLoS One Research Article BACKGROUND: Early diagnosis of human immunodeficiency virus (HIV) allows for appropriately timed interventions with improved outcomes, but HIV screening among asymptomatic persons and the general population in Singapore remains low. In 2008, Singapore’s Ministry of Health implemented HIV voluntary opt-out screening (VOS) for hospitalised adults. We evaluated the outcome of VOS and surveyed reasons for its low uptake in our institution. METHODS: We assessed the outcomes of the VOS programme from January 2010 to December 2013 at National University Hospital, a 1081-bed tertiary hospital in Singapore. We also examined reasons for opting-in and opting-out using an interviewer–administered structured questionnaire in a representative sample in January 2013. RESULTS: 107,523 patients fulfilled VOS criteria and were offered HIV screening, of which 5215 (4.9%) agreed to testing. 4850 (93.1%) of those who opted-in had an HIV test done. Three (0.06%) tested positive for HIV. 238 patients (14.2%) were surveyed regarding reasons for opting-in or out of VOS. 21 (8.8%) had opted-in. Patients who opted-in were likely to be younger, more educated and reported having more regular sexual partners. Type of housing, number of casual sexual partners, sexual orientation, intravenous drug use, condom use and previous sexually transmitted infection were not associated with deciding to opt-in/out. Patients’ most common reasons for opting-out were: belief that they were at low risk (50.2%), belief that they were too old (26.8%), cost (6.9%) and aversion to venepuncture (6.5%). The most common reason for opting-in was desire to know their HIV status (47.6%). CONCLUSION: The success of an HIV-VOS program is largely determined by test uptake. Our study showed that the majority of eligible VOS patients opted-out of HIV screening. Given the considerable cost and low yield of this programme, more needs to be done to better equip patients in self-risk assessment and opting in to testing. Public Library of Science 2015-01-22 /pmc/articles/PMC4303265/ /pubmed/25611741 http://dx.doi.org/10.1371/journal.pone.0116987 Text en © 1969 Tan et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Tan, Xin Quan
Goh, Wei-Ping
Venkatachalam, Indumathi
Goh, Diana
Sridhar, Revathi
Chan, Hwang Ching
Archuleta, Sophia
Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital
title Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital
title_full Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital
title_fullStr Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital
title_full_unstemmed Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital
title_short Evaluation of a HIV Voluntary Opt-Out Screening Program in a Singapore Hospital
title_sort evaluation of a hiv voluntary opt-out screening program in a singapore hospital
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303265/
https://www.ncbi.nlm.nih.gov/pubmed/25611741
http://dx.doi.org/10.1371/journal.pone.0116987
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