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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.110700v1 97/12/2173    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Owens, D. K. Articles by Holodniy, M. Search for Related Content PubMed PubMed Citation Articles by Owens, D. K. Articles by Holodniy, M. Related Collections HIV/AIDS Prevention Screening

Douglas K. Owens, MD, MS, Vandana Sundaram, MPH, Laura C. Lazzeroni, PhD, Lena R. Douglass, BS, Gillian D. Sanders, PhD, Kathie Taylor, MA, Ronald VanGroningen, MS, Vera M. Shadle, MHA, MHS, Valerie C. McWhorter, MD, Teodora Agoncillo, BS, Noreen Haren, MPH, Jill Nyland, RN, Patricia Tempio, MBA, MSPH, Walid Khayr, MD, Dennis J. Dietzen, PhD, Peter Jensen, MD, Michael S. Simberkoff, MD, Samuel A. Bozzette, MD and Mark Holodniy, MD

Douglas K. Owens, Vandana Sundaram, Lena R. Douglass, Kathie Taylor, Ronald VanGroningen, Patricia Tempio, and Mark Holodniy are with the VA Palo Alto Health-care System, Palo Alto, Calif. Laura C. Lazzeroni is with the Department of Health Research and Policy, School of Medicine, Stanford University, Stanford, Calif. Gillian D. Sanders is with the Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford. Vera M. Shadle and Peter Jensen are with the VA San Francisco Healthcare System, San Francisco, Calif. Valerie C. McWhorter, Teodora Agoncillo, and Samuel A. Bozzette, are with the VA San Diego Health-care System, San Diego, Calif. Noreen Haren and Michael S. Simberkoff are with the VA New York Harbor Healthcare System, New York, NY. Jill Nyland and Walid Khayr are with the VA North Chicago Healthcare System, Chicago, Ill. Dennis J. Dietzen is with the VA Memphis Healthcare System, Memphis, Tenn.

Correspondence: Requests for reprints should be sent to Douglas K. Owens, MD, MS, Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305-6019 (e-mail: owens{at}stanford.edu).

Objectives. We sought to determine the prevalence of HIV in both inpatient and outpatient settings in 6 Department of Veterans Affairs (VA) health care sites.

Methods. We collected demographic data and data on comorbid conditions and then conducted blinded, anonymous HIV testing. We conducted a multivariate analysis to determine predictors of HIV infection.

Results. We tested 4500 outpatient blood specimens and 4205 inpatient blood specimens; 326 (3.7%) patients tested positive for HIV. Inpatient HIV prevalence ranged from 1.2% to 6.9%; outpatient HIV prevalence ranged from 0.9% to 8.9%. Having a history of hepatitis B or C infection, a sexually transmitted disease, or pneumonia also predicted HIV infection. The prevalence of previously undocumented HIV infection varied from 0.1% to 2.8% among outpatients and from 0.0% to 1.7% among inpatients.

Conclusions. The prevalence of undocumented HIV infection was sufficiently high for routine voluntary screening to be cost effective in each of the 6 sites we evaluated. Many VA health care systems should consider expanded routine voluntary HIV screening.

This article has been cited by other articles:

				V Sundaram, L C Lazzeroni, L R Douglass, G D Sanders, P Tempio, and D K Owens A randomized trial of computer-based reminders and audit and feedback to improve HIV screening in a primary care setting Int J STD AIDS, August 1, 2009; 20(8): 527 - 533. [Abstract] [Full Text] [PDF]

				A. Qaseem, V. Snow, P. Shekelle, R. Hopkins Jr., D. K. Owens, and for the Clinical Efficacy Assessment Subcommittee Screening for HIV in Health Care Settings: A Guidance Statement From the American College of Physicians and HIV Medicine Association Ann Intern Med, January 20, 2009; 150(2): 125 - 131. [Abstract] [Full Text] [PDF]

				S P Tole, G D Sanders, A M Bayoumi, C M Galvin, T N Vinichenko, M L Brandeau, and D K Owens Cost-effectiveness of voluntary HIV screening in Russia Int J STD AIDS, January 1, 2009; 20(1): 46 - 51. [Abstract] [Full Text] [PDF]

				G. D. Sanders, A. M. Bayoumi, M. Holodniy, and D. K. Owens Cost-Effectiveness of HIV Screening in Patients Older than 55 Years of Age Ann Intern Med, June 17, 2008; 148(12): 889 - 903. [Abstract] [Full Text] [PDF]