Risk-Based Human Immunodeficiency Virus (HIV) Testing Fails to Detect the Majority of HIV-Infected Persons in Medical Care Settings

In order to assess opportunities for early HIV diagnosis in a comprehensive public health care system, the researchers undertook a retrospective review of patients newly diagnosed with HIV from September 2001 to December 2003.

Of 348 patients newly diagnosed with HIV, 120 (34 percent) had received medical care within the system during the three years prior to diagnosis. While 105 of the 120 patients had at least one previous interaction with the emergency room or urgent care center, only 12 HIV diagnoses (10 percent) were made in these two departments. Previously, 33 patients (28 percent) had presented with an STD or a clinical indicator of HIV.

In conclusion, the researchers reported that while one-third of patients newly diagnosed with HIV had clinical visits in the preceding three years, few of them presented with clinical conditions typically linked to HIV. "Targeted testing based on clinical presentations is not likely to result in substantially earlier HIV diagnosis," they wrote. "Routine screening in high prevalence settings could be more effective."

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