2009 US emergency department HIV testing practices

Richard E. Rothman, Yu Hsiang Hsieh, Leah Harvey, Samantha Connell, Christopher J. Lindsell, Jason Haukoos, Douglas A.E. White, Aleksandar Kecojevic, Michael S. Lyons

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Objectives: We characterize HIV testing practices and programs in US emergency departments (EDs) in 2009. Methods: A national Web-based survey of members of the National ED HIV Testing Consortium, participants in the 2007 Centers for Disease Control and Prevention (CDC)sponsored ED HIV Testing Workshops, all US academic EDs, and a weighted random sample of US community EDs with snowball sampling to recruit additional testing sites was conducted. Data collected included geographic location, estimated seroprevalence, indications for testing, method of consent, weekly number of tests, funding, and costs. Results: Of 619 sites surveyed, 338 (54.6%) responded. A total of 277 (82.0%) reported conducting any HIV testing, and 75 (22.2%) reported systematic HIV testing programs, operationally defined as having testing or screening organized at the departmental or institutional level. systematic HIV testing programs were concentrated in the Northeast, at high-volume urban EDs, and in regions with higher HIV/AIDS prevalence. Most systematic HIV testing programs had existed for less than or equal to 3 years, and nearly one third reported using an opt-out approach for consent. Among systematic HIV testing programs, the number of patients tested ranged from less than 1 to 2,100 tests per week. Overall, universal screening was the most commonly reported screening method reported overall, and rates of HIV positivity were consistently above the CDC threshold of 0.1%. Conclusion: The number of EDs conducting HIV testing has grown substantially since release of the 2006 CDC HIV testing recommendations. Although many EDs have systematic HIV testing programs, the majority do not. Ongoing surveillance will be required to quantify the evolution of ED-based HIV testing and the factors that facilitate or impede expanded translation.

Original languageEnglish (US)
Pages (from-to)S3-S9
JournalAnnals of emergency medicine
Issue number1 SUPPL.
StatePublished - Jul 2011

ASJC Scopus subject areas

  • Emergency Medicine


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