3275 Blood-borne virus seropositivity and staff acceptability in an opt-out, multi-centre emergency department screening programme

Aims and Objectives Blood-borne viruses (BBV) cause significant morbidity and mortality, with a high proportion being undiagnosed. Opt-out emergency department (ED) screening has increased the availability of BBV testing, particularly among groups underserved by existing services, but there is little evidence for its acceptability among staff, or its effectiveness among different demographic groups. Method and Design We conducted a mixed-methods service evaluation of an existing, multi-centre BBV screening programme over two years (January 2023-December 2024). Patients having bloods in three EDs were also tested for HIV, Hepatitis B (HBV) and Hepatitis C (HCV) on an opt-out basis. Staff perspectives and practices were prospectively assessed using a qualitative survey. Fixed-effects logistic regression was used to assess the effect of sociodemographic factors on seropositivity rates. Results and Conclusion 93,159 patients were tested. 2726 (2.9%) were positive for at least one BBV (higher in men (3.9%) and those of white (3.7%) and black ethnicity (5.0%)). 74 new cases of HIV and 380 new cases of HBV were diagnosed. Seropositivity rates were comparable to national averages (HIV 0.89%, HBV 1.1%, HCV 0.93%), with regression analyses showing seropositivity for BBVs was negatively associated with female gender, Asian (p<0.001), Mixed/Other (p=0.04) and unrecorded ethnicity (p<0.001). 219 staff responded to the survey; of staff collecting bloods every or most shifts, 100 (66.2%) reported BBV testing every time, with variation by profession (nursing staff 65.0%, EDAs 100%, resident doctors 43.8%). Participants reported several reasons for the importance of screening, including early detection of asymptomatic disease, preventing transmission and health promotion. This evaluation suggests opt-out screening for BBVs is acceptable to staff (with some variation by profession), and effective in identifying undiagnosed BBVs at a similar rate to the general population and across demographic groups. Further investigation is required to identify whether differences in identified seropositivity rates by ethnicity are attributable to differences in prevalence or service factors