Testing only high-risk or symptomatic patients for HIV is inadequate to identify the one-third of HIV-positive people in the United States who are unaware of their infections, according to a report detailing results of a new pilot study published in Archives of Internal Medicine (2002;162:887-892). "Identifying Undiagnosed Human Immunodeficiency Virus: The Yield of Routine, Voluntary Inpatient Testing" states that about 300,000 people in the United States are unaware they are infected with HIV and that routine, voluntary testing could identify many of them. Researchers implementing the "Think HIV" program found that routine, voluntary testing in all patients admitted to Boston Medical Center, which has a 1 percent prevalence of HIV among patients, tripled the likelihood that patients would undergo HIV testing compared with patients admitted prior to the program. Using this testing approach in 72 hospitals nationwide that have demographics similar to BMC would identify an additional 31,800 HIV-infected patients annually, compared with testing only high- risk or symptomatic patients, according to the researchers.

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