Selective HIV testing, better than volunteers

carry out testing HIV testing in hospital emergency departments This is an effective strategy for reducing the number of people with undiagnosed virus infection. The doubt seems to be “for whom”, as stated in an article published in The Lancet HIV, in which a program implemented by the Spanish Society of Emergency and Emergency Medicine (Semes) achieved good results compared with the British compared to similar strategies implemented.

The main author of this article is Juan González del Castillo, Semes Infection Team CoordinatorIt was highlighted that the need for explicit consent for HIV testing in our country represents an important obstacle to the application of the common strategy of voluntary exclusion from testing. Furthermore, a survey of the heads of 250 emergency services in Spain showed that they were unwilling to implement a universal HIV screening strategy.

Therefore, in order to reduce the number of people with undiagnosed HIV infection, the Spanish Society of Emergency Medicine (Semes), with the support of the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc), and with the support of Gilead Sciences, started work Targeted opt-in screening testing strategies This will apply to emergencies in our country.

The strategy includes requiring all users of these services to undergo HIV testing Meet any of the following six criteria

(Commonly seen in emergency rooms and associated with higher HIV prevalence): Sexually transmitted infections, herpes zoster (18 to 65 years old), community-acquired pneumonia (18 to 65 years old), mononucleosis, involved chemistry Sex or Requesting Post – Exposure Prevention.

Semmes chose a selective inclusion strategy because Be more effective, more profitable and gain more recognition from professionals Compared to an opt-out strategy. HIV testing in the emergency department is key to increasing detection rates of new HIV infections in individuals who are unaware of their seropositivity. Therefore, HIV testing in emergency departments should be widely promoted, with strategies adapted to different settings.

In order to implement these recommendations in emergency services, specific training is being carried out through: “Leave your mark” program.

Groundbreaking program figures

►The project mentioned in the article in The Lancet HIV is called Make Your Mark.

►The initiative has been implemented in 121 emergency services agencies in Spain.

► During 2021 and 2022, a total of 66,813 HIV tests were conducted.

►These tests resulted in 901 new diagnoses of the disease.

►These results are converted into ratios

The HIV detection rate is 1.35%.