Hunt Bijou R, White Douglas A E, Glick Nancy R
Sinai Infectious Disease Center, Sinai Health System, Chicago, IL, USA.
Department of Emergency Medicine, Alameda Health System, Highland Hospital, Oakland, CA, USA.
J Int Assoc Provid AIDS Care. 2025 Jan-Dec;24:23259582251372446. doi: 10.1177/23259582251372446. Epub 2025 Aug 28.
People with a previous HIV diagnosis (PWHDx) who are out of care (OOC) (PWHDx OOC) represent a significant but often overlooked population in the United States, accounting for nearly half of new HIV transmissions annually. Emergency departments (EDs), frequently accessed by PWHDx OOC for unscheduled care, are uniquely positioned to identify and re-engage these individuals in HIV care. While ED-based HIV efforts have traditionally focused on diagnosing new infections, this paper reviews and evaluates 3 models EDs can implement to identify PWHDx OOC: routine HIV screening, health information exchange, and electronic health record alerts. We describe each model using examples from the literature, assessing their feasibility, scalability, and effectiveness in identifying patients and determining care status. By synthesizing current approaches, this paper highlights practical and policy-relevant pathways for expanding ED-based HIV services beyond diagnosis, offering concrete guidance for healthcare systems aiming to meet the national "Ending the HIV Epidemic" goals.
既往有HIV诊断史但失访的人群（PWHDx OOC）在美国是一个数量可观但常被忽视的群体，每年新增HIV传播病例中近一半来自该群体。急诊室（ED）是PWHDx OOC经常因非预约护理而前往的地方，在识别这些个体并使其重新参与HIV护理方面具有独特优势。虽然传统上基于急诊室的HIV工作重点是诊断新感染病例，但本文回顾并评估了急诊室可用于识别PWHDx OOC的三种模式：常规HIV筛查、健康信息交换和电子健康记录警报。我们通过文献中的实例描述每种模式，评估其在识别患者和确定护理状态方面的可行性、可扩展性和有效性。通过综合当前方法，本文突出了将基于急诊室的HIV服务从诊断扩展到其他方面的实用且与政策相关的途径，为旨在实现国家“终结HIV流行”目标的医疗系统提供了具体指导。
