Universal HIV Testing and Prevention Services in Emergency Departments in South Africa and Baltimore

What this Trial Is About

Researchers are evaluating how many patients with HIV or at high risk of HIV visit Emergency Departments ED in South Africa and how HIV services can be integrated into this setting. The study aims to assess the opportunity to provide HIV prevention methods like pre-exposure prophylaxis PrEP and to improve testing and care linkage through a strategy called Universal Test and Connect UTC. This approach seeks to reduce new HIV infections and AIDS-related deaths by universally testing patients and connecting them to long-term care, including referrals for PrEP. The study involves universal HIV testing of all patients attending two busy 24-hour EDs in Cape Town, regardless of risk factors. Healthcare providers in the ED will collect demographic and clinical information to identify patients eligible for PrEP. Additionally, in-depth interviews and surveys will be conducted with ED nurses, physicians, and advanced practice providers to understand their perspectives on delivering PrEP in this setting. The UTC strategy will be integrated into the clinical workflow to assess feasibility and acceptance. Participants will undergo point-of-care HIV testing and provide information to determine PrEP eligibility. Providers will participate in interviews and surveys using a structured guide to evaluate their views on PrEP delivery. Researchers will measure the proportion of patients eligible for PrEP, prevalence of conditions like tuberculosis or renal dysfunction among them, and provider acceptance of ED-based PrEP services. The study will monitor these outcomes at baseline and after UTC implementation, aiming to improve HIV prevention and care access in the ED environment.

Universal Test and Connect for HIV Service Delivery in South Africa