WORLD AIDS DAY 2020
Keeping HIV Screening on the Radar During COVID
University of Chicago study demonstrates feasibility, value of capturing ER populations
BY PAUL SCHINDLER
With COVID cases
surging to staggeringly
unprecedented
levels nationwide
and New York City facing the risk
of a sustained second wave of infections,
a study of the HIV testing
protocols in a hospital emergency
room at the University of Chicago
demonstrates the feasibility and
the value of encouraging such testing
even in the face of a crushing
pandemic.
The university’s emergency
room has prioritized routine HIV
testing since 2011 because it represents
an ideal location for identifying
HIV diagnoses separate from
those discovered in more targeted
outreach efforts.
Efforts to end HIV/ AIDS as
an epidemic, such as that undertaken
by New York State and the
city since 2015, rely, in part, on
early diagnoses of the virus so that
those infected can quickly begin
treatment to reduce their viral load
to the point where they cannot infect
others even through condomless
anal sex contacts.
The study, published by the peerreviewed
journal AIDS and Behavior
and covering the early weeks of
the COVID outbreak in Chicago,
noted that identifying individuals
newly-infected with HIV, during
which time they experience an
initial acute infection stage where
their virus is highly transmissible,
is particularly important.
Patients in emergency rooms —
arriving with serious symptoms
they’ve never experienced before
— are an important population to
reach with HIV testing since the
symptoms could indicate infection
and, separate from such an
ER visit, they might be unlikely to
seek out regular medical care.
The onset of the COVID pandemic
makes the emergency room
all the more appropriate as a venue
for HIV testing, the university ER
leadership immediately recognized.
Fears in the general public about
COVID was driving up the number
of people with infl uenza-like
Dr. Kimberly Stanford, an emergency medicine specialist at the University of Chicago and one of the
investigators in a study of screening patients visiting emergency rooms during the COVID crisis for HIV.
Amida Care’s briefi ng paper on COVID-19’s impact on New York’s Plan to End the HIV Epidemic.
illness (ILI) to seek out emergency
room care while those symptoms
could instead indicate the acute
infection state of someone newly
infected with HIV.
Results reported in the AIDS
and Behavior study covered the
period from March 5 to April 18.
A follow-up presentation by two of
FAST TRACK CITIES 2020
AMIDA CARE
the study’s investigators at September’s
Fast Track Cities Conference
of the International Association of
Providers of AIDS Care pointed to
the success the university ER had
in identifying a higher than typical
number of acute HIV infections
as it simultaneously tackled the
COVID crisis.
In preparing for the expected arrived
of COVID in Chicago, the ER
set aside a large temporary space
for patients presenting ILI symptoms
but unlikely to require full
hospitalization.
Part of that planning involved
incorporating HIV testing into the
diagnostic work performed, which
initially sparked some resistance
from ER staff who felt that COVID
needed to be the sole focus of their
efforts given the enormity of that
challenge.
Leaders in the ER, however, emphasized
the similarities in symptoms
between potential COVID
cases and possible acute HIV infections,
a message received well
by those initially unconvinced,
accord to the AIDS and Behavior
study.
Outside of the temporary ILI
evaluation space, the ER’s normal
HIV screening efforts also continued.
In a virtual session at the Fast
Track Cities Conference in September,
two of the investigators
— emergency medicine specialist
Dr. Kimberly A. Stanford and
infectious disease specialist Dr.
David Pitrak — reported that the
emergency room in the fi rst eight
months of 2020 identifi ed nine
cases of acute HIV infection. That
compared to full-year results for
2016 through 2019 of seven, seven,
four, and seven, respectively.
Asked during the virtual presentation
to explain the ER’s increased
identifi cation of acute HIV
infections, Stanford said, “I think
one of the interesting things about
COVID is that it is bringing people
to the hospital seeking care who
might otherwise not have come,
so people who might otherwise
have thought, ‘Oh, I have the fl u,
I have a cold,’ and stayed home,
now they’re so scared that they
might have COVID they are actually
coming to the hospital to seek
care and as a result this is our opportunity
to screen them for HIV
and oftentimes now we’re fi nding a
few HIV cases in these suspected
➤ HIV TESTING IN COVID ERA, continued on p.16
November 26 - December 2,8 2020 | GayCityNews.com
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