Hospitals to increase screenings for HIV
To help stop disease’s spread, pair will test some ER patients
As San Antonio continues to grapple with high rates of HIV, two area hospitals will expand screenings for the virus soon by testing some patients in emergency rooms.
On Nov. 1, Metropolitan Methodist Hospital will begin testing for HIV and hepatitis C in ER patients who are between the ages of 16 and 65 and already are undergoing blood work. The screening will be opt-out, meaning the tests will be conducted on those patients unless they decline.
The tests will be free to patients, with the cost paid by a grant from Gilead Sciences, a biotechnology company that develops drugs for diseases such as HIV, the flu and hepatitis B and C.
University Health System already tests for hepatitis C but will add an HIV test for patients having blood work done at University Hospital’s emergency department and its outpatient clinics, said Dr. Roberto Villarreal, vice president of research and information management for UHS.
Last week, UHS obtained more money through
the Texas Department of State Health Services for HIV screening. UHS expects that its expanded testing will also start this fall, Villarreal said.
The goal is to identify people who may be unaware they have HIV, get them into treatment more quickly and prevent further spread of the illness.
The screenings are slated to begin as city and county officials, along with community organizations, work to reduce the San Antonio area’s high HIV rates, which for years have remained above state and national averages.
In 2018, more than 6,400 people in Bexar County were living with HIV, and 338 people received a new diagnosis over the course of the year, according to state health data.
Bexar County has been identified as a hot spot for new HIV diagnoses by the federal government in its plan to reduce transmissions of the virus by 90 percent over the next decade.
Metropolitan, located just north of downtown, sees about 50,000 patients in its ER each year, some of whom may be at risk for HIV or hepatitis C, said Dr. Diana Henderson, the hospital’s chief medical officer.
By making the testing routine, Henderson said, the hospital hopes patients will feel more at ease about learning their HIV or hepatitis C status. If a person does test positive, they will be connected to treatment through a patient specialist.
The hospital is in the process of training staff to sensitively handle the screenings, Henderson said.
“Health care providers need the words to present that to patients, working on that scripting to say, ‘Look, we do the test on everybody. Do you consent to having the test?’” she said. “Rather than asking about sexual partners and practices and things like that, that is difficult for people to talk about and has some sense of judgment in it.”
In the absence of grant funding, Henderson said, HIV screening programs can be difficult for hospitals to financially sustain over time. Insurers often decline to cover tests that are not ordered in connection with a patient’s symptoms, she said.
Villarreal said UHS decided to expand HIV testing beyond University Hospital’s ER because some people, while seeking primary care at UHS outpatient clinics, have learned they have HIV.
The testing initiatives also dovetail with other recent efforts to reduce the spread of HIV and hepatitis C. This month, Bexar County commissioners approved $80,000 in funding for a needle exchange program. Research shows that such programs help reduce rates of those diseases.