HIV and Hepatitis C Virus Screening in the Emergency Department and Linkage to Care During COVID-19: Challenges and Solutions

Lara-Paez, George; Zuazo, Miriam; Blumenthal, Jill; Coyne, Christopher J.; Hoenigl, Martin

ABSTRACT The recent global pandemic of coronavirus disease-19, also known as COVID-19, has posed significant challenges to Emergency Department (ED) HIV and HCV screening programs as well as linkage to care efforts in those identified with HIV or HCV infections. The goal of this educational report was to describe challenges in the face of the COVID-19 pandemic and solutions, focusing on our HIV and HCV opt-out universal ED screening program at the University of California San Diego (UCSD) Medical Center, San Diego, CA, USA. Our automated, routine HIV and HCV ED screening program continued high-level screening during the peak of the COVID-19 pandemic, although absolute numbers were reduced by about one-third, in line with a reduced ED census. Although linkage to care procedures continued during the pandemic, COVID-19 played a significant role in slowing the process, particularly in relinkage of known HIV-positive patients and in linkage of HCV-positive patients. Further efforts are needed to improve linkage to care processes in the era of COVID-19, especially as cases are rising in the United States.