Increasing HIV screening in a secondary hospital emergency department in Brazil: searching for opportunities

Detalhes bibliográficos
Autor(a) principal: Moura, Rafael Jardim de
Data de Publicação: 2024
Outros Autores: Valente, Pablo K., Romero, Gustavo Adolfo Sierra
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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spelling 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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dc.identifier.uri.fl_str_mv https://preprints.scielo.org/index.php/scielo/preprint/view/8072
10.1590/SciELOPreprints.8072
url 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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dc.publisher.none.fl_str_mv SciELO Preprints
SciELO Preprints
SciELO Preprints
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SciELO Preprints
SciELO Preprints
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