Development and Pilot Testing of a Persuasive Health Communication Intervention for Emergency Department Patients Who Decline Rapid HIV/HCV Screening

Emergency departments (EDs) are an ideal venue to conduct screening for both HIV and HCV, given the high prevalence of HIV and HCV risk-taking behaviors among ED patients (e.g., sexual risk and drug use, particularly injection-drug use during the current opioid epidemic in the US); the known feasibility and acceptability of HIV and HCV screening in this setting; the proven yield of identifying those with undiagnosed infections in the ED; and the ability to link those with infections to subsequent care after the ED visit. Screening for both infections in EDs is preferable due to: (1) the shared overlap of some risk behaviors for HIV and HCV acquisition (e.g., drug use), (2) the relatively high co-occurrence of these infections in some populations, (3) the more complex medical needs and worse sequelae for those co-infected, and (4) efficiency. Despite the strong rationale for ED HIV/HCV screening, best practices on how to conduct screening so to maximize patient screening uptake have yet to be identified. This current R34 project will gain invaluable preliminary data for a subsequent R01 randomized, controlled trial that ultimately aims to determine if: (1) a persuasive health communication intervention can convince those who initially decline screening to be tested; (2) emergency department (ED) medical staff or HIV/HCV counselors should conduct opt-out, rapid HIV/HCV screening; and (3) if ED medical staff or HIV/HCV counselors using the intervention are better at convincing patients to be tested for HIV and HCV. The project's definitive purpose is to help identify evidence-based practices to improve ED HIV/HCV screening.

Tao Liu Staff 1 Research Assistant i

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