1. Bradley C. Fetzer M.D. M.P.H., Florence Momplaisir, M.D. M.S.H.P., Judith A. Long M.D.
.
 HIV testing rates fall well below rates
of other chronic disease screening in
this cohort.
 Populations whose primary source of
care lies in community health clinics,
emergency rooms, or report none or
‘other’ non-private sources of care
are more likely to receive HIV testing
compared with traditional private
clinics.
 While community health clinics are
comparable to private clinics in rates
of routine chronic disease screening,
not surprisingly those who report the
ED or none or ‘other’ as their primary
source of care are less likely to
receive routine chronic disease
screening.
 Primary Care Physicians:
 Adhere well to screening
guidelines for blood pressure and
cancer screening.
 May neglect appropriately
screening their populations for
HIV.
ConclusionsBackground
 Data: 2002-2010 Southeastern Pennsylvania (SEPA) Household survey, which is the largest and
most comprehensive health survey in Pennsylvania. It is administered every two years and
evaluates the health status and health care experiences of adults living in the region.
 Weighted survey data used to compare:
Number of people ever tested for HIV and tested within the prior year.
Number of people who reported age and sex appropriate chronic disease screening:
• Blood Pressure Screening, Cervical Cancer Screening, Breast Cancer Screening, and
Colorectal Cancer Screening (Colonoscopy or Sigmoidoscopy)
 Logistic regression performed to determine likelihood of ever having received HIV testing and
chronic disease screening between respondents, by primary source of care.
Methods
Proposal ID #: 1638481
Variable Name N % 95% CI
Reported HIV Test, Prior Yr. 8939 17.6 10.7-24.6
Reported HIV Test, Ever 21882 44.4 52.0-57.0
BP Screen, Prior Yr. 45527 89.8 89.3-90.3
Pap Smear, Prior 2 Yrs. 21700 83.6 82.4- 84.9
Pap Smear, Ever 25611 95.9 95.4-96.3
Mammography, Prior 2 Yrs. 13899 82.6 81.2-83.9
Mammography, Ever 16024 92.8 92.0 -93.8
GI Endoscopy, Prior 10 Yrs. 13306 58.2 55.9-60.6
GI Endoscopy, Ever 14212 62.2 59.6-64.9
Table 1: Proportion of Respondents Tested
Screening Measure OR 95 % CI
HIV Test, Ever
Community Health Clinic 1.94 1.51-2.51
ED 3.33 0.92-8.28
Source of Care None/Other 1.49 1.23-1.52
BP Screen, Prior year
Community Health Clinic 0.23 0.05-1.03
ED 0.03 0.01-0.15
Source of Care None/Other 0.14 0.07-0.26
Pap Smear, Ever
Community Health Clinic 1.62 0.51-5.13
ED 0.40 0.22-0.73
Source of Care None/Other 0.38 0.29-0.50
Mammogram, Ever
Community Health Clinic 0.77 0.37-1.62
ED 0.25 0.13-0.51
Source of Care None/Other 0.50 0.39-0.65
Colonoscopy, Ever
Community Health Clinic 0.91 0.58-1.43
ED 3.12 0.35-27.9
Source of Care None/Other 0.71 0.59-0.85
Table 2: Odds of Testing and Screening in
other Settings Compared to Private Clinics
Results
 Routine opt-out HIV testing has been
recommended by the CDC since 2006 and
proposed by the USPSTF in 2013
Overall rates of HIV testing have
increased since 2006 CDC
recommendations.
 Increase in rates largely attributable to:
• Community Clinics
• Emergency Departments
• Non-traditional Primary Care settings
 Primary Care Providers have reported
multiple barriers to routine opt-out HIV
testing.
 Data regarding actual HIV testing practices
of primary providers is lacking.
Objective:
 Determine how rates of HIV testing
compare with other routine screening
measures overall & in the primary care
setting .
 Gain a better under standing of HIV
testing practices by private practice
primary care providers.
Results
 50,698 individuals surveyed, ≈ 10,000/yr.
 Mean age 40 yrs., majority Caucasian
(69.2%) and female (53.3%).
 Primary source of medical care:
 79.1 % Private Clinic
 4.2% Community Health Clinic
 2.5% Emergency Department
 14.2% reported as none or ‘other’
OR - Odds Ratio; ED - Emergency Department