Results from a New York City emergency department rapid HIV testing program.

BACKGROUND

The US Centers for Disease Control and Prevention recommends expanded HIV screening in emergency departments (EDs). The additional value of ED screening programs remains controversial.

METHODS

Patients were rapid-tested for HIV via fingerstick Oraquick in a counselor-based testing program at 2 university-hospital affiliated EDs in New York City in 2006-2007. Data were from a testing program database, supplemented by electronic medical record (EMR) review.

RESULTS

Of 2,569 ED patients who underwent rapid HIV testing, 31 were preliminary positive; all diagnoses were confirmed by Western blot (1.2%, 95%CI 0.8%, 1.7%). Seven patients had previous HIV diagnoses and 24 (0.7%, 95% CI 0.6%, 1.4%) were considered new diagnoses. Of the new diagnoses, ten had hospital visits in the year before diagnosis, 7 of whom had visited only the ED. Linkage to care, defined as a visit with an HIV provider, was documented for 17.

CONCLUSIONS

ED rapid HIV testing programs can contribute substantially to HIV screening efforts and may identify persons with previously undiagnosed HIV infection who are not tested in other hospital settings. Linkage to care may be difficult, despite extensive testing program outreach.