Evidence map›Paper›PMID 26731757›Full record

ArticleAIDS (London, England)2016

Improvements in the continuum of HIV care in an inner-city emergency department.

Gabor D Kelen, Yu-Hsiang Hsieh, Richard E Rothman, Eshan U Patel, Oliver B Laeyendecker, Mark A Marzinke, William Clarke, Teresa Parsons, Jordyn L Manucci, Thomas C Quinn

Registry-linked trialAbstract read
In one paragraph

Article in AIDS (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04793750 (Ending the HIV Epidemic Through Point-of-Care Technologies), which is not on this map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04793750 nacompletednot on this mapstarted 2021, after this paper: background citation

Ending the HIV Epidemic Through Point-of-Care Technologies (EHPOC): Performance Evaluation of Novel POC HIV Tests in Baltimore

TypeinterventionalSponsorJohns Hopkins UniversityRan2021 to 2025Enrolled224ConditionsHIV Infections, SyphilisArmsCepheid GeneXpert HIV-1 Qual POC HIV VL test, DPP HIV-Syphilis test system, OraQuick
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 32 citations in OpenAlex.

  1. Discordant performance of mpox serological assays.Journal of virological methods · 2024
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  9. "Take an HIV Test Kit Home": A Pilot Randomized Controlled Trial Among HIV High-risk Urban ED Patients.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2020
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Gabor D KelenaDepartment of Emergency Medicine, Johns Hopkins University School of Medicine, BaltimorebDivision of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, BethesdacDepartment of PathologydDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Yu-Hsiang Hsieh
Richard E Rothman
Eshan U Patel
Oliver B Laeyendecker
Mark A Marzinke
William Clarke
Teresa Parsons
Jordyn L Manucci
Thomas C Quinn
Johns Hopkins Medicine · USJohns Hopkins University · USNational Institutes of Health · USNational Institute of Allergy and Infectious Diseases · US

Funding

International Studies of the Acquired Immune Deficiency Syndrome (AIDS)ZIAAI000361 · NIAID · NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES · PI REDD, ANDREW · 2009 to 2025
$15.8M
Cost-Effectiveness of ED HIV Testing Program Agent-Based Modeling ApproachK01AI100681 · NIAID · JOHNS HOPKINS UNIVERSITY · PI HSIEH, YU-HSIANG · 2012 to 2015
$532k
Intramural NIH HHS Z99 AI999999NIAID NIH HHS K01 AI100681NIAID NIH HHS K01AI100681
6 · The paper itself

Abstract

objectiveThe Johns Hopkins Hospital Emergency Department has served as a window on the HIV epidemic for 25 years, and as a pioneer in emergency department-based screening/linkage-to-care (LTC) programs. We document changes in the burden of HIV and HIV care metrics to the evolving HIV epidemic in inner-city Baltimore. DESIGN/

methodsWe analyzed seven serosurveys conducted on 18 ,144 adult Johns Hopkins Hospital Emergency Department patients between 1987 and 2013 as well as our HIV-screening/LTC program (2007, 2013) for trends in HIV prevalence, cross-sectional annual incidence estimates, undiagnosed HIV, LTC, antiretrovirals treatment, and viral suppression.

resultsHIV prevalence in 1987 was 5.2%, peaked at more than 11% from 1992 to 2003 and declined to 5.6% in 2013. Seroprevalence was highest for black men (initial 8.0%, peak 20.0%, last 9.9%) and lowest for white women. Among HIV-positive individuals, proportion of undiagnosed infection was 77% in 1987, 28% in 1992, and 12% by 2013 (P < 0.001). Cross-sectional annual HIV incidence estimates declined from 2.28% in 2001 to 0.16% in 2013. Thirty-day LTC improved from 32% (2007) to 72% (2013). In 2013, 80% of HIV-positive individuals had antiretrovirals ARVs detected in sera, markedly increased from 2007 (27%) (P < 0.001). Proportion of HIV-positive individuals with viral suppression (<400 copies/ml) increased from 23% (2001) to 59% (2013) (P < 0.001).

conclusionEmergency department-based HIV testing has evolved from describing the local epidemic to a strategic interventional role, serving as a model for early HIV detection and LTC. Our contribution to community-based HIV-screening and LTC program parallels declines in undiagnosed HIV infection and incidence, and increases in antiretroviral use with associated viral suppression in the community.

Indexed as

Continuity of Patient CareQuality of Health CareAdolescentAdultAgedAged, 80 and overBaltimoreEmergency Medical ServicesFemaleHIV InfectionsHumansMaleMiddle AgedYoung Adult

Identifiers

PMID26731757
PMCPMC4704105
OpenAlexW2466932457

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.