{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:52:31Z","timestamp":1781265151887,"version":"3.54.1"},"reference-count":60,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T00:00:00Z","timestamp":1597795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Centers for Disease Control and Prevention (CDC) recommend universal human immunodeficiency virus (HIV) screening starting at 13\u00a0years, which has been implemented in many general U.S. emergency departments (EDs) but infrequently in pediatric EDs. We aimed to 1) implement a pilot of routine adolescent HIV screening in a pediatric ED and 2) determine the unique barriers to CDC\u2010recommended screening in this region of high HIV prevalence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective 4\u2010month implementation of a routine HIV screening pilot in a convenience sample of adolescents 13 to 18\u00a0years at a single pediatric ED, based on study personnel availability. Serum\u2010based fourth\u2010generation HIV testing was run through a central laboratory. Parents were allowed to remain in the room for HIV counseling and testing. Data were collected regarding patient characteristics and HIV testing quality metrics. Comparisons were made using chi\u2010square and Fisher's exact tests. Regression analysis was performed to assess for an association between parent presence at the time of enrollment and adolescent decision to participate in HIV screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 4\u00a0months, 344 of 806 adolescents approached consented to HIV screening (57% female, mean\u00a0\u00b1\u00a0SD\u00a0=\u00a015.1\u00a0\u00b1 1.6\u00a0years). Adolescents with HIV screening were more likely to be older than those who declined (p\u00a0=\u00a00.025). Other blood tests were collected with the HIV sample for 21% of adolescents; mean time to result was 105\u00a0minutes (interquartile range\u00a0=\u00a069 to 123) and 79% were discharged before the result was available. Having a parent present for enrollment was not associated with adolescent participation (adjusted odds ratio\u00a0=\u00a01.07, 95% CI\u00a0=\u00a00.67 to 1.70). Barriers to testing included: fear of needlestick, time to results, cost, and staff availability. One of 344 tests was positive in a young adolescent with Stage 1 HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Routine HIV screening in adolescents was able to be implemented in this pediatric ED and led to the identification of early infection in a young adolescent who would have otherwise been undetected at this stage of disease. Addressing the unique barriers to adolescent HIV screening is critical in high\u2010prevalence regions and may lead to earlier diagnosis and treatment in this vulnerable population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14095","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T19:44:00Z","timestamp":1595879040000},"page":"984-994","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Unique Needs for the Implementation of Emergency Department Human Immunodeficiency Virus Screening in Adolescents"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6113-5799","authenticated-orcid":false,"given":"Colleen K.","family":"Gutman","sequence":"first","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Duda","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Newton","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Alevy","sequence":"additional","affiliation":[{"name":"Morehouse School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Palmer","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Wetzel","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Figueroa","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Griffiths","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"},{"name":"and the Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Koyama","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"},{"name":"and the Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Middlebrooks","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"},{"name":"and the Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold K.","family":"Simon","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"},{"name":"and the Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Camacho\u2010Gonzalez","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"},{"name":"and the Grady Infectious Disease Program Ponce Family and Youth Clinic Grady Health Systems Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia R.","family":"Morris","sequence":"additional","affiliation":[{"name":"From the Department of Pediatrics Emory University School of Medicine Atlanta GA USA"},{"name":"Children's Healthcare of Atlanta Atlanta GA USA"},{"name":"and the Department of Emergency Medicine Emory University School of Medicine Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,19]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"HIV Surveillance Report 2018 (Preliminary).Atlanta:Centers for Disease Control and Prevention;2019."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13809"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13491"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2020.0033"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000151079.33935.79"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1110187"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1506816"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105243"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1600693"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6811e1"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002359"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002219"},{"key":"e_1_2_7_14_1","first-page":"1","article-title":"Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health\u2010care settings","volume":"55","author":"Branson BM","year":"2006","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.953"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.07.004"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2012.01401.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12987"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/hiv.12474"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.11.027"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0033354919860510"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.101.6.987"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.154.4.361"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.09.009"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6708a1"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13867"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.08.023"},{"key":"e_1_2_7_28_1","unstructured":"Centers for Disease Control and Prevention.Estimated HIV incidence and prevalence in the United States 2010\u20132016. HIV Surveillance Supplemental Report 2019.24(1).2019. Available at:http:\/\/www.cdc.gov\/hiv\/library\/reports\/hiv\u2010surveillance.html. Accessed Mar 26 2020."},{"key":"e_1_2_7_29_1","unstructured":"U.S. Department of Health & Human Services.What is \u2018Ending the HIV Epidemic: a plan for America\u2019?HIV.gov. Published Feb 26 2020. Available at:https:\/\/www.hiv.gov\/federal\u2010response\/ending\u2010the\u2010hiv\u2010epidemic\/overview. Accessed Mar 26 2020."},{"key":"e_1_2_7_30_1","unstructured":"HIV Surveillance Summary Georgia 2017. Georgia Department of Public Health HIV\/AIDS Epidemiology Section.2019. Available at:https:\/\/dph.georgia.gov\/data\u2010fact\u2010sheet\u2010summaries. Accessed Mar 30 2020."},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9588-z"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549161310S111"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182a21611"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.05.021"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0237"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.03.026"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0b013e3182850910"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.07.027"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2007.0098"},{"key":"e_1_2_7_40_1","unstructured":"RuiP KangK.National Hospital Medical Care Survey: 2017 Emergency Department Summary Tables. Available at:https:\/\/www.cdc.gov\/nchs\/data\/nhamcs\/web_tables\/2017_ed_web_tables\u2010508.pdf. Accessed Mar 27 2020."},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2009.06.015"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2013.09.018"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2015.12.011"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104282"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000855"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2017.05.004"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2005.08.008"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3326"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2009.08.003"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2013.07.029"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549161310S109"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/pq9.0000000000000248"},{"key":"e_1_2_7_53_1","first-page":"432","article-title":"The effect of an electronic \u201chard\u2010stop\u201d alert on HIV testing rates in the emergency department","volume":"192","author":"Schnall R","year":"2013","journal-title":"Stud Health Technol Inform"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocx118"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocy112"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1177\/0033354917690732"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.03.021"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2011.03.039"},{"key":"e_1_2_7_59_1","unstructured":"Georgia Integrated HIV Prevention & Care Plan 2017\u20102021.2016. Available at:http:\/\/www.ryanwhiteatl.org\/wp\u2010content\/uploads\/2016\/09\/Georgia\u2010Integrated\u2010HIV\u2010Plan\u2010Fulton\u2010County\u2010H89HA00007.pdf. Accessed Mar 31 2020."},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.117075"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.04.017"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facem.14095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14095","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/acem.14095","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.14095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T23:35:31Z","timestamp":1693870531000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.14095"}},"subtitle":[],"editor":[{"given":"Elizabeth","family":"Alpern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,8,19]]},"references-count":60,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1111\/acem.14095"],"URL":"https:\/\/doi.org\/10.1111\/acem.14095","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,19]]},"assertion":[{"value":"2020-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}