AIDSWEEKLY Plus; Monday, July 4, 2005
Staff Medical Writers

"Accessing at-risk and underserved populations for intervention remains a major obstacle for public health programs. Emergency departments (EDs) care for patients not otherwise interacting with the health care system, and represent a venue for such programs," scientists in the United States report.

"A variety of perceived and actual barriers inhibit widespread implementation of ED-based public health programs. Collaboration between local health departments and EDs may overcome such barriers.

"The goal of this study was to assess the effectiveness of a health department-funded, ED-based public health program in comparison with other similar community-based programs through analysis of data reported by health department-funded HIV counseling and testing centers in one Ohio county," said M.S. Lyons and colleagues at the University of Cincinnati.

"Data for HIV counseling and testing at publicly funded sites in southwestern Ohio from January 1999 through December 2002 were obtained from the Ohio Department of Health. Demographic and risk-factor profiles were compared between the counseling and testing program located in the ED of a large, urban teaching hospital and the other publicly funded centers in the same county," investigators wrote.

"A total of 26,382 patients were counseled and tested; 5,232 were ED patients, and 21,150 were from community sites. HIV positivity was 0.86% (95% confidence interval [CI] 0.64%, 1.15%) in the ED and 0.65% (95% CI 0.55%, 0.77%) elsewhere. The ED program accounted for 19.8% of all tests and 24.7% of all positive results.

"The ED notified 77.3% of individuals testing positive and 84.4% of individuals testing negative. At community program centers," continued the authors, "88.3% of patients testing positive and 63.8% of patients testing negative were notified of results. All ED patients notified of positive status were successfully referred to infectious disease specialists."

Lyons concluded, "Public health programs can operate effectively in the ED. EDs should have a rapidly expanding role in the national public health system."

Lyons and colleagues published their study in Public Health Reports (Health department collaboration with emergency departments as a model for public health programs among at-risk populations. Public Health Rep, 2005;120(3):259-265).

For more information, contact M.S. Lyons, University of Cincinnati, Medical Center, Institute Study Health, 231 Albert Sabin Way, POB 670769, Cincinnati, OH 45267, USA.

Publisher contact information for the journal Public Health Reports is: Association Schools Public Health, 1101 15TH St. NW, Ste. 910, Washington, DC 20005, USA.

Keywords: Cincinnati, Ohio, United States, Emergency Medicine, Public Health, HIV/AIDS, Health Education.

This article was prepared by AIDS Weekly editors from staff and other reports.

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