No thanks, says this emergency physician.
Shadowfax cites a litany of reasons, including HIV not being relevant to many patient complaints, worsening delays, taking on liability, and the lack of counseling services for positive tests.
To a lesser extent, similar obstacles exist in primary care offices, despite the recent ACP recommendation to screen everyone over the age of 13.
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{ 2 comments }
I definitely don’t think they should. I really agree, the test is only accurate to 3 months before the time of test, so it is not a true negative. Also the lack of counseling/education if there was a positive or even negative result poses a serious threat to the psychologic well being of the patient.
I worked in a sexual health centre doing the Rapid HIV testing for a semester. I can tell you the people need the education about what the test is going to tell them, what their risks ACTUALLY were, and are. There is a change to prepare them is a chance to prepare them if they are at risk, and then we connected them to the resources they needed to follow up with and could rely on for support.
I really don’t see any time that the ER should be providing this test, unless is it absolutely critical to know.
I don’t go near ER’s as a physician, but it seems to me that emergency rooms exist for treating emergency conditions and any additional requirements detract from their ability to do that most effectively. Attention and resources are limited. Every action comes at a cost.
If a physican or healthcare facility says “I do x and specialize in x and open my doors to people in need of x” then they do that in order to do x most effectively focusing 100% on that.
It is not for anyone else to try to tell them that they have to do y and z also.
Emergency rooms should test for HIV if it is needed to manage the emergency at hand. For all other services they should feel free to refer to the appropriate setting with the availability of ongoing care and calm, measured education.
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