Please answer the following questions to the best of your abilities.
1. Which of the following best describes your current position or level of training?
*
Resident
Fellow
Attending
Other (please specify)
2. Do you currently care for patients < 21 years of age in the emergency department (ED) setting in your routine clinical practice? *
Yes
No
I do not practice clinically
3. Do you currently practice medicine in the United States of America?
*
Yes
No
We are interested in examining HIV testing patterns from the Emergency Department and looking at baseline knowledge.
**Please base your answers on what you know rather than a best guess or using any outside references.** Thank you.
The following questions relate to screening and consent. Screening is defined as the examination of a group of people, whether symptomatic or asymptomatic, to detect a specific disease or disorder.
Adolescents are defined as persons between the ages of 13-21.
4. According to the Centers for Disease Control and Prevention (CDC), HIV screening is recommended for:
5. According to the CDC, HIV screening is recommended to be performed:
6. Please answer the following items to the best of your knowledge without referring to any outside references.
Yes No Do not
know The CDC recommends a separate written consent form for HIV testing (that is unique from the consent form for general
emergency medical care).
My state requires a written consent form for HIV testing that is unique from the consent form for general emergency
medical care.
All adolescents and adults > 13 years of age
All adolescents and adults > 18 years of age
Sexually active adolescents and adults
None of the above
I do not know
At the primary care provider office
At sexually transmitted infection (STI) clinics
In the ED
In all health care settings, including the ED
I do not know
Other
7. Per the CDC, high risk patients include:
• Injection-drug users and their sex partners
• Persons who exchange sex for money or drugs
• Sex partners of HIV-infected persons
• Men who have sex with men
• Heterosexual persons who have had multiple sex partners since their most recent HIV test
According to the CDC, how often is HIV screening recommended for all high-risk patients?
At least every three months
At least annually
At least every 2 years
At least every 5 years
I do not know
8. Which HIV testing method is available from your ED? Please select all that apply.
Rapid HIV testing (examples: OraQuick Advance®, Reveal™, Uni-Gold™ Recombigen®, Multispot-oral swab, fingerstick or venipuncture)
HIV antibody test (e.g. standard 3rd generation ELISA)
HIV PCR
There is no option for HIV testing from my ED
I do not know which tests are available
9. Please choose one answer choice for each of the questions below.
10. Who determines which patients should be tested for HIV in your ED? Please select all that apply.
Yes No Do not
know In your ED, do well-defined protocols exist regarding which adolescent patients should be offered HIV screening? Does your ED use multimedia modalities (i.e. computer-based, web-based, video) to provide HIV counseling and
education?
Does your institution’s ED have a dedicated HIV health educator available for HIV counseling and testing? A health educator is defined as someone hired specifically to educate patients about behaviors that can help prevent diseases, injuries and other health problems.
Physicians
Nurses
Health educators
Social workers
Other (please specify)
11. Questions 11-13 refer to your opinions regarding screening in adolescent patients.
Strongly
Disagree Disagree Neither Agree
nor Disagree Agree Strongly Agree
Adolescents are at high risk for contracting HIV. Sexually transmitted infection screening should be
offered to all adolescents in the ED.
Emergency practitioners have a responsibility to offer HIV
screening to all adolescents in the ED.
ED-based HIV screening helps increase access to HIV testing for adolescents.
I feel confident in my knowledge of the indications and
procedures for HIV testing in adolescents.
HIV screening for all adolescents presenting to the ED is
an overall societal cost-effective measure.
12. Please provide your responses to the following questions.
Strongly
Disagree Disagree Neither Agree
nor Disagree Agree Strongly
Agree Screening for HIV in the ED is too time-consuming. Screening for sexually transmitted infections in the ED is too time-
consuming.
Pre-test and post-test counseling significantly lengthen the time
required to screen for HIV in the ED, irrespective of the test result. I am hesitant to test for HIV because a positive HIV test result would
require too much time for me to address in the ED setting.
It is difficult to discretely test adolescents for HIV in the ED when
accompanied by their parents or guardians.
Adolescents with non-sexual health complaints are more likely to refuse
HIV screening.
It is difficult to ensure appropriate follow-up for patients with HIV tests
sent from the ED setting.
I would be more likely to offer HIV screening for adolescent patients if
there were established follow-up from the ED.
I would be more likely to offer HIV screening for adolescent patients if point-of-care HIV testing were available in my ED (results available during the ED visit).
I feel confident in my ability to identify which adolescents should be screened for HIV in the ED setting.
13. Please consider having a full complement of resources available in your ED when answering the following questions.
I would offer HIV testing in the ED setting...
14. If not tested in the ED setting, I refer my adolescent patients at risk for HIV to a different ambulatory setting for HIV testing.
15. I would offer testing for STIs (e.g. chlamydia, gonorrhea) to any adolescent presenting to the ED, regardless of chief complaint.
Strongly
Disagree Disagree Neither Agree
nor Disagree Agree Strongly
Agree If there were a clinical suspicion for HIV or AIDS in my patient. For an adolescent presenting for a suspected sexual assault. When clinical suspicion for any sexually transmitted infection (e.g.
chlamydia, gonorrhea) is present.
To adolescent patients who report any unprotected sexual intercourse. To any adolescent presenting to the ED, regardless of chief complaint.
Never
Rarely
Sometimes
Most of the times
Always
Strongly Disagree
Disagree
Neither Agree nor Disagree
Agree
Strongly Agree
16. Please provide your responses to the following questions.
Strongly
Disagree Disagree Neither Agree
nor Disagree Agree Strongly
Agree Outpatient resources for adolescent HIV testing are readily available
within my community.
I would prefer to offer HIV testing to more adolescents during their ED visits but I feel I have limited resources available to me.
I feel uncomfortable delivering the results of HIV testing to adolescents. I would be more likely to offer HIV testing to adolescents in the ED if a
dedicated health educator was available to assist with HIV counseling and testing.
Regardless of CDC or state requirements, I feel consent from a parent/guardian should be obtained prior to testing for HIV in an adolescent.
I feel uncomfortable testing for HIV in adolescents due to my religious, spiritual or cultural beliefs.
17. Which best describes your primary practice setting?
18. Which best describes your primary practice setting?
19. Which best describes your primary practice setting?
20. Which best describes your hospital’s annual ED volume?
21. How many years have you been a practicing attending physician in Emergency Medicine?
University-based medical center
University-affiliated medical center
Community Hospital
Urban
Suburban
Rural
Free-standing children’s hospital
Non-free-standing children’s hospital
Pediatric ED within general hospital
General ED with both adult and pediatric patients
<20,000
21,000-40,000
41,000-60,000
>61,000
22. Are you board certified / board eligible in Pediatric Emergency Medicine?
23. Are you pediatric emergency medicine fellowship trained?
24. To your best knowledge, what percentage of the patients you care for in your ED are 13-21 years of age?
25. In the past six months, how many times have you obtained an HIV test on an adolescent patient from the ED?
26. How many of the HIV tests you sent in the past six months were for sexual assault concerns?
27. In which state do you predominantly practice?
The following questions are optional.
Yes
No
Yes
No
<20%
21-50%
51-75%
76-100%
0
1-2
3-4
5-10
≥11
≤10%
11-25%
26-50%
51-75%
≥76%
29. What is your ethnicity?
30. What is your race?
Female
Hispanic or Latino
Not Hispanic or Latino
Multi-ethnic
Other (please specify)
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Multi-racial
Other
