Open Access Research article

Comparison of patient comprehension of rapid HIV pre-test fundamentals by information delivery format in an emergency department setting

Roland C Merchant123*, Erin M Gee1, Melissa A Clark2, Kenneth H Mayer24, George R Seage3 and Victor G DeGruttola5

Author Affiliations

1 Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

2 Department of Community Health, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

3 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA

4 Department of Medicine, Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

5 Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, USA

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BMC Public Health 2007, 7:238  doi:10.1186/1471-2458-7-238

Published: 12 September 2007

Abstract

Background

Two trials were conducted to compare emergency department patient comprehension of rapid HIV pre-test information using different methods to deliver this information.

Methods

Patients were enrolled for these two trials at a US emergency department between February 2005 and January 2006. In Trial One, patients were randomized to a no pre-test information or an in-person discussion arm. In Trial Two, a separate group of patients were randomized to an in-person discussion arm or a Tablet PC-based video arm. The video, "Do you know about rapid HIV testing?", and the in-person discussion contained identical Centers for Disease Control and Prevention-suggested pre-test information components as well as information on rapid HIV testing with OraQuick®. Participants were compared by information arm on their comprehension of the pre-test information by their score on a 26-item questionnaire using the Wilcoxon rank-sum test.

Results

In Trial One, 38 patients completed the no-information arm and 31 completed the in-person discussion arm. Of these 69 patients, 63.8% had twelve years or fewer of formal education and 66.7% had previously been tested for HIV. The mean score on the questionnaire for the in-person discussion arm was higher than for the no information arm (18.7 vs. 13.3, p ≤ 0.0001). In Trial Two, 59 patients completed the in-person discussion and 55 completed the video arms. Of these 114 patients, 50.9% had twelve years or fewer of formal education and 68.4% had previously been tested for HIV. The mean score on the questionnaire for the video arm was similar to the in-person discussion arm (20.0 vs. 19.2; p ≤ 0.33).

Conclusion

The video "Do you know about rapid HIV testing?" appears to be an acceptable substitute for an in-person pre-test discussion on rapid HIV testing with OraQuick®. In terms of adequately informing ED patients about rapid HIV testing, either form of pre-test information is preferable than for patients to receive no pre-test information.