Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities
Autor(a) principal: | |
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Data de Publicação: | 2024 |
Outros Autores: | , |
Tipo de documento: | preprint |
Idioma: | eng |
Título da fonte: | SciELO Preprints |
Texto Completo: | https://preprints.scielo.org/index.php/scielo/preprint/view/8072 |
Resumo: | Patients seeking emergency care have higher HIV prevalence than the general population, but HIV testing is often not offered in these settings, constituting missed opportunities for HIV testing. Semi structured interviews were conducted withemergency department health workers in a secondary hospital in Brazil. Interviews were recorded, transcribed, and analyzed for themes related to barriers and facilitator to HIV testing in emergency departments (EDs) and strategies to implement HIV screening programs. Currently, most providers reported only offering HIV testing when suspecting that the health problem that motivated the patient to seek care could be HIV-related. Although some providers believed that EDs would not be appropriate to implement screening programs, acceptability of HIV screening programs in this setting was overall high, particularly among nurses. Barriers to increasing HIV testing in EDs included concerns about time, understaffing, and increased costs. The initial triage was identified as a leverage point to obtain consent for HIV screening. Advantages and limitations of HIV screening programs at initial triage, testing blood samples collected for other reasons, and for patients undergoing emergency surgical procedures are discussed. EDs in medium income countries constitute a potential scenario to implement HIV screening programs, and such programs may benefit from empowering nursing staff to that end. |
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Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunitiesHIV infectionMass screeningEmergency healthcareImplementation scienceInfecções por HIVTriagem em massaCuidados de saúde de emergênciaCiência da implementaçãoPatients seeking emergency care have higher HIV prevalence than the general population, but HIV testing is often not offered in these settings, constituting missed opportunities for HIV testing. Semi structured interviews were conducted withemergency department health workers in a secondary hospital in Brazil. Interviews were recorded, transcribed, and analyzed for themes related to barriers and facilitator to HIV testing in emergency departments (EDs) and strategies to implement HIV screening programs. Currently, most providers reported only offering HIV testing when suspecting that the health problem that motivated the patient to seek care could be HIV-related. Although some providers believed that EDs would not be appropriate to implement screening programs, acceptability of HIV screening programs in this setting was overall high, particularly among nurses. Barriers to increasing HIV testing in EDs included concerns about time, understaffing, and increased costs. The initial triage was identified as a leverage point to obtain consent for HIV screening. Advantages and limitations of HIV screening programs at initial triage, testing blood samples collected for other reasons, and for patients undergoing emergency surgical procedures are discussed. EDs in medium income countries constitute a potential scenario to implement HIV screening programs, and such programs may benefit from empowering nursing staff to that end.Los pacientes que acuden a urgencias presentan una prevalencia del VIH superior a la de la población general, pero a menudo no se ofrecen pruebas del VIH en estos entornos, lo que constituye una pérdida de oportunidades para realizarlas. Se realizaronentrevistas semiestructuradas a trabajadores sanitarios del servicio de urgencias de un hospital secundario de Brasil. Las entrevistas fueron grabadas, transcritas y analizadas en busca de temas relacionados con las barreras y los facilitadores de las pruebas del VIH en los servicios de urgencias (SU) y las estrategias para implementar programas de cribado del VIH. En la actualidad, la mayoría de los proveedores informaron que sólo ofrecen la prueba del VIH cuando sospechan que el problema de salud que motivó al paciente a buscar atención podría estar relacionado con el VIH. Aunque algunos proveedores creían que los SUH no serían apropiados para implementar programas de cribado, la aceptación de los programas de cribado del VIH en este entorno era en general alta, especialmente entre las enfermeras. Los obstáculos para aumentar las pruebas del VIH en los SUH incluían la preocupación por el tiempo, la falta de personal y el aumento de los costes. El triaje inicial se identificó como un punto de apoyo para obtener el consentimiento para el cribado del VIH. Se discuten las ventajas y limitaciones de los programas de cribado del VIH en el triaje inicial, el análisis de muestras de sangre recogidas por otras razones, y para los pacientes sometidos a procedimientos quirúrgicos de emergencia. Los SUH de países de renta media constituyen un escenario potencial para implementar programas de cribado del VIH, y dichos programas pueden beneficiarse de la capacitación del personal de enfermería para tal fin.Os pacientes que procuram atendimento de emergência têm maior prevalência de HIV do que a população em geral, mas o teste de HIV muitas vezes não é oferecido nesses ambientes, o que constitui oportunidades perdidas para o teste de HIV. Foram realizadas entrevistas semiestruturadas com profissionais de saúde do departamento de emergência em um hospital secundário no Brasil. As entrevistas foram gravadas, transcritas e analisadas quanto a temas relacionados a barreiras e facilitadores do teste de HIV em departamentos de emergência (EDs) e estratégias para implementar programas de triagem de HIV. Atualmente, a maioria dos provedores relatou que só oferece testes de HIV quando suspeita que o problema de saúde que motivou o paciente a procurar atendimento pode estar relacionado ao HIV. Embora alguns provedores acreditassem que os departamentos de emergência não seriam apropriados para implementar programas de triagem, a aceitabilidade dos programas de triagem de HIV nesse ambiente foi, em geral, alta, especialmente entre os enfermeiros. As barreiras para aumentar os testes de HIV nos DEs incluíam preocupações com o tempo, falta de pessoal e aumento dos custos. A triagem inicial foi identificada como um ponto de alavancagem para obter o consentimento para a triagem de HIV. São discutidas as vantagens e as limitações dos programas de triagem de HIV na triagem inicial, no teste de amostras de sangue coletadas por outros motivos e para pacientes submetidos a procedimentos cirúrgicos de emergência. As salas de emergência em países de renda média constituem um cenário em potencial para a implementação de programas de triagem de HIV, e esses programas podem se beneficiar da capacitação da equipe de enfermagem para esse fim.SciELO PreprintsSciELO PreprintsSciELO Preprints2024-02-27info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/807210.1590/SciELOPreprints.8072enghttps://preprints.scielo.org/index.php/scielo/article/view/8072/15056Copyright (c) 2024 Rafael Jardim de Moura, Pablo K. Valente, Gustavo Adolfo Sierra Romerohttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessMoura, Rafael Jardim deValente, Pablo K.Romero, Gustavo Adolfo Sierrareponame:SciELO Preprintsinstname:Scientific Electronic Library Online (SCIELO)instacron:SCI2024-02-10T19:19:30Zoai:ops.preprints.scielo.org:preprint/8072Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2024-02-10T19:19:30SciELO Preprints - Scientific Electronic Library Online (SCIELO)false |
dc.title.none.fl_str_mv |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
title |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
spellingShingle |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities Moura, Rafael Jardim de HIV infection Mass screening Emergency healthcare Implementation science Infecções por HIV Triagem em massa Cuidados de saúde de emergência Ciência da implementação |
title_short |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
title_full |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
title_fullStr |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
title_full_unstemmed |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
title_sort |
Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities |
author |
Moura, Rafael Jardim de |
author_facet |
Moura, Rafael Jardim de Valente, Pablo K. Romero, Gustavo Adolfo Sierra |
author_role |
author |
author2 |
Valente, Pablo K. Romero, Gustavo Adolfo Sierra |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Moura, Rafael Jardim de Valente, Pablo K. Romero, Gustavo Adolfo Sierra |
dc.subject.por.fl_str_mv |
HIV infection Mass screening Emergency healthcare Implementation science Infecções por HIV Triagem em massa Cuidados de saúde de emergência Ciência da implementação |
topic |
HIV infection Mass screening Emergency healthcare Implementation science Infecções por HIV Triagem em massa Cuidados de saúde de emergência Ciência da implementação |
description |
Patients seeking emergency care have higher HIV prevalence than the general population, but HIV testing is often not offered in these settings, constituting missed opportunities for HIV testing. Semi structured interviews were conducted withemergency department health workers in a secondary hospital in Brazil. Interviews were recorded, transcribed, and analyzed for themes related to barriers and facilitator to HIV testing in emergency departments (EDs) and strategies to implement HIV screening programs. Currently, most providers reported only offering HIV testing when suspecting that the health problem that motivated the patient to seek care could be HIV-related. Although some providers believed that EDs would not be appropriate to implement screening programs, acceptability of HIV screening programs in this setting was overall high, particularly among nurses. Barriers to increasing HIV testing in EDs included concerns about time, understaffing, and increased costs. The initial triage was identified as a leverage point to obtain consent for HIV screening. Advantages and limitations of HIV screening programs at initial triage, testing blood samples collected for other reasons, and for patients undergoing emergency surgical procedures are discussed. EDs in medium income countries constitute a potential scenario to implement HIV screening programs, and such programs may benefit from empowering nursing staff to that end. |
publishDate |
2024 |
dc.date.none.fl_str_mv |
2024-02-27 |
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info:eu-repo/semantics/preprint info:eu-repo/semantics/publishedVersion |
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preprint |
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publishedVersion |
dc.identifier.uri.fl_str_mv |
https://preprints.scielo.org/index.php/scielo/preprint/view/8072 10.1590/SciELOPreprints.8072 |
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https://preprints.scielo.org/index.php/scielo/preprint/view/8072 |
identifier_str_mv |
10.1590/SciELOPreprints.8072 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://preprints.scielo.org/index.php/scielo/article/view/8072/15056 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2024 Rafael Jardim de Moura, Pablo K. Valente, Gustavo Adolfo Sierra Romero https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2024 Rafael Jardim de Moura, Pablo K. Valente, Gustavo Adolfo Sierra Romero https://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
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application/pdf |
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SciELO Preprints SciELO Preprints SciELO Preprints |
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SciELO Preprints SciELO Preprints SciELO Preprints |
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