HIV Infections Clinical Trial
Official title:
Randomised Study Comparing Two HIV Screening Strategies in the Emergency Department Using an Electronic Tablet Questionnaire: The PETTSEQ Study (PErformance of Two Testing Strategies by Electronic Questionnaire)
A randomised, single-blind study (the study investigator will not know which arm each patient is assigned to) conducted to examine the most effective strategy for conducting HIV testing in the Emergency Department (ED) using an electronic tablet. The study will take place in the ED at Lausanne University Hospital (LUH) between August and December 2015 in the context of the Masters project of a medical student studying at the Faculty of Medicine at Lausanne University.
In Switzerland, the national HIV testing recommendations have proposed targeted and
diagnostic HIV testing since 2007. These recommendations list medical conditions and
populations at risk in which HIV testing is indicated. The difficulty with this targeted
approach is that it relies on medical personnel 1) to be aware that the medical conditions
listed have an association with HIV infection and 2) to be able to identify their patients
as coming from at-risk populations. In other countries, notably the United States, France
and the United Kingdom, national HIV testing recommendations propose non-targeted screening
whereby everyone presenting to a medical facility is tested if the HIV seroprevalence in the
catchment population is above a defined threshold (0.1% for the US and France; 0.2% for the
UK). As HIV seroprevalence in Switzerland already exceeds these thresholds, the current
study will be performed to see whether non-targeted HIV testing using electronic tablets is
acceptable and feasible in our Emergency Department (ED).
ED patients will be randomised to a targeted or non-targeted arm after consenting to
participate. Eighty patients will be assigned to each study arm. Participating patients will
be issued with an electronic tablet and invited to follow the instructions on the screen.
Targeted arm patients will be invited to complete a questionnaire on HIV risk factors and,
if one or more risk factors are present, they will be informed that HIV testing is indicated
and will be invited to take a free rapid HIV test. Non-targeted arm patients will be
provided with information about HIV and HIV testing and will then be invited to take a free
rapid HIV test without any questions regarding risk factors. Patients in each arm who are
either not offered (targeted arm) or who decline rapid testing (non-targeted arm) will
undergo secondary cross-screening in which targeted arm patients will be automatically
directed by the tablet to the non-targeted arm information page and non-targeted arm
patients will be directed to the targeted arm questionnaire. The primary endpoint is patient
acceptance of HIV testing. The secondary objective is to examine the effect of
cross-screening strategies.
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