Routine HIV Screening in the Emergency Department Using the New U.S. Centers for Disease Control and Prevention Guidelines: Results From a High-Prevalence Area

CDC's latest guidelines for routine HIV testing, released in 2006, include recommendations that emergency departments (EDs) offer routine opt-out screening to their patients. The authors established a testing program implementing these recommendations at an urban university hospital ED in Washington, D.C. In the current study, they reported on the results of this program.

Over the course of three months, ED patients being treated for a wide range of conditions were approached by trained HIV screeners and offered point-of-care rapid HIV testing. Patients with positive results were given referrals to a hospital or community resources for confirmatory testing and treatment.

A total of 14,986 patients were treated in the ED during the program period, of whom 4,151 (27.6 percent) were offered HIV screening. Mean patient age was 37.5 years; 48.5 percent were black; 39.0 percent were non-Hispanic white; 4.1 percent were Hispanic; 1.7 percent were Asian; while 6.7 percent self-identified as being of another race. Most patients lived in the Washington, D.C., metropolitan area, and 56.1 percent were female. Of those offered HIV testing, 2,476 (59.7 percent) accepted. Twenty-six of these had a preliminary positive screen, of whom 13 were lost to follow-up, nine were Western blot-confirmed positive, and four were confirmed negative by Western blot. Eight of the nine patients with confirmed HIV infection were successfully linked to follow-up care.

"The implementation of the CDC recommendations establishing routine opt-out HIV screening programs in EDs is feasible," the authors concluded. "Further efforts to establish routine ED HIV testing are therefore warranted."

Back to other news for November 2007