Rapid HIV testing is a new technology that speeds receipt of HIV test results and might increase access to testing. Its use in emergency departments (EDs) has been demonstrated, but patient acceptance of rapid testing in the ED has not been optimal. It is likely the low acceptance is partially due to ED patients not realizing their personal risk of acquiring an HIV infection and therefore their need to learn their HIV status. Dr. Merchant proposes to: (1) develop a novel means of data collection to obtain HIV risk factor and testing histories from ED patients using a handheld, Tablet PC, audio computer-administered interviewer (ACASI); and (2) design an intervention using the ACASI to enhance ED patients' awareness of their personal risk of becoming HIV infected and encourage them to undergo rapid HIV testing in the ED. Dr. Merchant will conduct his study in three phases. In Phase I, he will determine the baseline acceptance proportion among patients at the Rhode Island Hospital ED through a randomized, prospective trial with 610 patients. In Phase II, he will develop and pilot test the questionnaire, messages, and intervention for Phase III. In Phase III, he will conduct a randomized, prospective, pilot study with 1,220 ED patients to evaluate the effectiveness of the ACASI-based intervention in regards to willingness to undergo rapid HIV testing, and to the utility and ED patient acceptance of obtaining HIV risk factor and testing histories using the ACASI. Dr. Merchant will continue his training to become an independent researcher in HIV and other infectious diseases preventive health concerns as they relate to emergency medicine. Concurrent with his planned research, Dr. Merchant will complete his doctoral degree in infectious diseases epidemiology from the Harvard School of Public Health. The research from this proposal will become the basis of his thesis. He will be mentored by internationally-known experts in HIV research from biostatistics, epidemiology, and clinical medicine at both Brown University and Harvard University.
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