Author(s): Brown J, Shesser R, Simon G, Bahn M, Czarnogorski M,
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Abstract BACKGROUND: In 2006, the US Centers for Disease Control and Prevention (CDC) released new recommendations for routine HIV testing. Among these were recommendations that emergency departments (EDs) offer routine opt-out HIV screening to their patients. We established a screening program implementing these recommendations at an urban university hospital ED in Washington, DC. We report the results of this program. METHODS: During a 3-month period, 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 referred to hospital or community resources for confirmatory testing and treatment. RESULTS: During the program period, 14,986 patients were treated in the ED and 4151 (27.6\%) were offered HIV screening. The mean patient age was 37.5 years; 48.5\% were black, 39.0\% were non-Hispanic white, 4.1\% were Hispanic, 1.7\% were Asian, and 6.7\% responded as being other race. A total of 56.1\% were female, and most lived within the Washington, DC metropolitan area. Of the patients offered HIV screening, 2476 (59.7\%) accepted the test. Of the 26 patients with a preliminary positive screen, 13 were lost to follow-up, 9 were confirmed positive by Western blot, and 4 were confirmed negative by Western blot. Eight of the 9 patients with confirmed HIV infection were successfully linked to follow-up care. CONCLUSIONS: The implementation of the CDC recommendations establishing routine opt-out HIV screening programs in EDs is feasible. Further efforts to establish routine ED HIV testing are therefore warranted.
This article was published in J Acquir Immune Defic Syndr
and referenced in Journal of Clinical Case Reports