Integrating rapid HIV testing in emergency care improves HIV detection

Emergency departments (EDs) offer an important venue to identify undiagnosed human immunodeficiency virus (HIV) infection, supporting the Center for Disease Control and Prevention's priorities to increase awareness of HIV serostatus as outlined in "Healthy People 2010." Beginning in late 2004, New Jersey began supporting the introduction of voluntary opt-in rapid HIV testing at EDs, using staff at nearby publicly funded counseling and testing sites. Analysis of the experience at 1 site shows that testing could readily be expanded into the ED: 56% of patients offered testing agreed to be tested, and all patients tested received pretest and posttest counseling. Of the 1054 patients tested, 6 were HIV positive, with 5 of those 6 representing newly diagnosed HIV infections, all 5 of whom were referred for care and treatment. The success of this pilot supports the New Jersey and Center for Disease Control and Prevention efforts to expand rapid testing to more EDs nationwide and demonstrates the important role that EDs need to play in the fight against HIV.