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Demographic disparities in blood-borne-virus screening in two London Emergency Departments: a case for implied consent.

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Title: Demographic disparities in blood-borne-virus screening in two London Emergency Departments: a case for implied consent.
Authors: Fairhead, Cassandra, Barber, Tristan J., Okhai, Hajra, Durkin, Russell, Hart, Jennifer, Pinto, Jessica, Hunter, Alan, Macdonald, Douglas, Burns, Fiona
Source: AIDS Care. May2025, Vol. 37 Issue 5, p855-863. 9p.
Subjects: Bloodborne infections, Interviewing, Sex distribution, Hospital emergency services, Retrospective studies, Multivariate analysis, Descriptive statistics, Age distribution, HIV infections, Odds ratio, Race, Attitudes of medical personnel, Research methodology, Research, Medical screening, Sociodemographic factors, Confidence intervals, Health care reminder systems, Time, Employees' workload
Geographic Terms: England
Abstract: "Opt-out" Emergency Department (ED) blood-borne-virus screening enables early diagnosis, improving outcomes. Whereas some EDs encourage verbal reminders at blood draw, others emphasise "implied consent". Associations between these approaches and screening equity have not been explored. This retrospective cohort evaluation quantified demographic disparities in screening in two EDs following "reminder model" screening rollout. Staff attitudes were explored, identifying screening barriers. ED attendees from July-October 2022 were identified electronically. Associations between age, sex, self-identified ethnicity, attendance time and admission status on screening were analysed using odds ratios (ORs). Twenty ED staff underwent semi-structured interviews. There were 33,388 eligible ED attendances (54.8% female; median age 53y). 58.9% of attendees received screening. In unadjusted analysis, the screening rate was higher in men (OR 1.05; 95%CI 1.00–1.10) and in non-admitted attendees. People of Black, Asian or Other ethnic backgrounds had lower rates compared to White ethnicity. Attendees between 5pm–11pm had lower rates and 11pm–9am higher rates compared to 9am–5pm. All associations persisted in multivariable models. Interviews revealed low confidence in follow-up discussion in attendees who opted out and a high workload precluding screening. Demographic disparities were seen in this "reminder model" context. Simplifying processes and emphasising implied consent may improve equitable screening. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Demographic disparities in blood-borne-virus screening in two London Emergency Departments: a case for implied consent.
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  Data: <searchLink fieldCode="JN" term="%22AIDS+Care%22">AIDS Care</searchLink>. May2025, Vol. 37 Issue 5, p855-863. 9p.
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  Data: <searchLink fieldCode="DE" term="%22Bloodborne+infections%22">Bloodborne infections</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Sex+distribution%22">Sex distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br /><searchLink fieldCode="DE" term="%22Multivariate+analysis%22">Multivariate analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Age+distribution%22">Age distribution</searchLink><br /><searchLink fieldCode="DE" term="%22HIV+infections%22">HIV infections</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Race%22">Race</searchLink><br /><searchLink fieldCode="DE" term="%22Attitudes+of+medical+personnel%22">Attitudes of medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+screening%22">Medical screening</searchLink><br /><searchLink fieldCode="DE" term="%22Sociodemographic+factors%22">Sociodemographic factors</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Health+care+reminder+systems%22">Health care reminder systems</searchLink><br /><searchLink fieldCode="DE" term="%22Time%22">Time</searchLink><br /><searchLink fieldCode="DE" term="%22Employees'+workload%22">Employees' workload</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22England%22">England</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: "Opt-out" Emergency Department (ED) blood-borne-virus screening enables early diagnosis, improving outcomes. Whereas some EDs encourage verbal reminders at blood draw, others emphasise "implied consent". Associations between these approaches and screening equity have not been explored. This retrospective cohort evaluation quantified demographic disparities in screening in two EDs following "reminder model" screening rollout. Staff attitudes were explored, identifying screening barriers. ED attendees from July-October 2022 were identified electronically. Associations between age, sex, self-identified ethnicity, attendance time and admission status on screening were analysed using odds ratios (ORs). Twenty ED staff underwent semi-structured interviews. There were 33,388 eligible ED attendances (54.8% female; median age 53y). 58.9% of attendees received screening. In unadjusted analysis, the screening rate was higher in men (OR 1.05; 95%CI 1.00–1.10) and in non-admitted attendees. People of Black, Asian or Other ethnic backgrounds had lower rates compared to White ethnicity. Attendees between 5pm–11pm had lower rates and 11pm–9am higher rates compared to 9am–5pm. All associations persisted in multivariable models. Interviews revealed low confidence in follow-up discussion in attendees who opted out and a high workload precluding screening. Demographic disparities were seen in this "reminder model" context. Simplifying processes and emphasising implied consent may improve equitable screening. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=184921793
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    Identifiers:
      – Type: doi
        Value: 10.1080/09540121.2025.2477721
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      – Code: eng
        Text: English
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        PageCount: 9
        StartPage: 855
    Subjects:
      – SubjectFull: Bloodborne infections
        Type: general
      – SubjectFull: Interviewing
        Type: general
      – SubjectFull: Sex distribution
        Type: general
      – SubjectFull: Hospital emergency services
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Multivariate analysis
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      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: HIV infections
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Race
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      – SubjectFull: Attitudes of medical personnel
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      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Research
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      – SubjectFull: Medical screening
        Type: general
      – SubjectFull: Sociodemographic factors
        Type: general
      – SubjectFull: Confidence intervals
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      – SubjectFull: Health care reminder systems
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      – SubjectFull: Time
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      – SubjectFull: Employees' workload
        Type: general
      – SubjectFull: England
        Type: general
    Titles:
      – TitleFull: Demographic disparities in blood-borne-virus screening in two London Emergency Departments: a case for implied consent.
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              Text: May2025
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