Using implementation science to support the adoption of routine HIV testing in a suburban emergency department

ABSTRACT

Background: Implementation science (IS) involves using techniques to promote implementation of evidence-based guidance to improve healthcare quality and outcomes. Sutton has an HIV prevalence rate of 2.5/1000 and a high late diagnosis rate. Testing in emergency departments (ED) has been shown to be effective and has been adopted in many UK metropolitan centres. Routine testing in EDs of high prevalence areas is recommended by NICE. Method(s) Our project started in November 2019 and was designed to promote uptake of opt-out HIV testing into routine practice through education, training, and incentives. Strategies employed outlined in table 1. We assessed acceptability and adoption of the guidance. Result(s) HIV testing increased from average 7.5 tests/ month to 592 tests/month (17,165 tests in 28 months). Three previously undiagnosed people and 1 individual with a known diagnosis who had disengaged were identified. Testing numbers ranged from 191-1229/month. Numbers dropped during the following challenging periods 1. Tendering of the sexual health service 2. IT and sample processing issues on implementation 3. Emergence of SARS CoV-2 4. Blood bottle shortage in 2021 Conclusion(s) This project demonstrated that while implementation of routine opt out HIV testing in ED is feasible and acceptable, it took a long time for the practice to be embedded and it was easily de-railed by external circumstances. Acknowledgements- This project was conducted with support from an Implementation Science grant by ViiV. (Table Presented).