ED Based HIV Screening

The Centers for Disease Control and Prevention (CDC) estimate that as many as 25 percent of the 1.2 million Americans who are HIV positive are unaware that they are carrying the virus. Early detection has been shown to reduce risk behaviors and can link infected patients to care. CDC recommends voluntary HIV screening for adult and adolescent patients in healthcare settings. Emergency Departments-based testing can be an effective strategy for screening to hard-to-reach populations for HIV.

Who should be part of a team to implement HIV testing in the ED? Will a particular program's approach achieve its goals? How do you measure progress? To guide clinicians and administrators through the process of planning, implementing, or expanding ED-based HIV testing program, HRET has developed a Web-based operational guide. This comprehensive resource is the first of its kind and is based on interviews and site visits with emergency departments that have pioneered ED-based HIV testing. HRET is continuing to build upon existing tools and resources to increase HIV screening in EDs.

To read the executive summary that covers the findings of HRET's 2004 survey of U.S. hospitals, please click here.

To learn more, and to access the web-based guide, visit www.edhivtestguide.org.

HRET has also developed a free online toolkit to help hospitals maximize reimbursement for HIV testing and screening. The toolkit includes a calculator that hospitals or clinics can use to estimate the cost of starting or expanding a screening program. To access the toolkit, visit www.hret.org/hiv-cost.

Additional Resources:

• Clinicians advised to increase routine HIV testing
  Click here to read the perspective piece in JAMA.
• Health facilities in Houston step up routine testing for HIV
  Click here to read the news in the Houston Chronicle.
• NYC hospitals to widely offer rapid HIV tests
  Click here< to read the news. Why EDs are fertile grounds for HIV testing
  Click here to read the article in H&HN.
• NCCC compiles new map of state HIV testing laws
  Click here to view the map.
• Listserv on HIV testing in hospital emergency departments
  To join this network of professionals to exchange ideas and gain new insights on ED-based HIV testing, please click here.
• Materials from 11.13.08. Audio Conference on Implementation Routing
  HIV Screening in Community Health Centers
  Slides
  NACHC HIV Testing Redesign Virtual Office
  Audio Recording
• APHA Annual Meeting, Philadelphia, December 10-14, 2005:
  Emergency Department-Based HIV Testing: Facilitators and Barriers
• AcademyHealth Annual Research meeting, Boston, June 26-28, 2005:
  Standard and Rapid HIV Testing Practices in Safety Net Hospitals
• Issue Brief: Adoption of Rapid HIV Testing in Hospitals
• Hospital HIV Testing Policies and Practices, A National Survey
  This summary covers findings of HRET’s 2004 survey of U.S. hospitals.
• FDA-Approved Rapid HIV Tests: Comparison Chart
  This chart compares FDA-approved rapid HIV tests currently available for purchase. For more information, please contact listed manufacturers directly.
• FDA Approved Rapid HIV Tests: Purchasing Information Chart
  This chart shares information relevant to decisionmakers as they consider which of the FDA approved rapid HIV tests would best fit their institution's needs. The chart compares price, manufacturer, operating temperatures, # of tests per box, presence of external control, and other important purchasing details.
• Comparison Chart of FDA-Approved HIV1&2 Enzyme-Linked Immunosorbent Assays (ELISA or EIAs)
  This chart compares FDA-approved HIV 1 and 2 ELISA or EIA tests currently available for purchase. For further information, please contact listed manufacturers directly.
• HRET Hospital HIV Testing Survey
  In spring of 2004, this HRET survey was sent to all non-federal, short-term hospitals in the US.
• Prevention and Hospitals: Bibliography
• Emergency Department HIV Testing: Bibliography
• Map of State HIV Testing Laws from the National HIV/AIDS Clinicians’ Consultation Center at UCSF
• Map on Testing in Jurisdictions with Elevated Incidence of HIV or AIDS Among Women
• HRET's Perinatal HIV Prevention Project
  Learn more about HRET's efforts to eliminate perinatal HIV transmission in US hospitals.
• CDC's Rapid HIV Testing Web Site
  These pages include descriptions of the rapid HIV tests approved by the FDA, how the tests can be implemented in different settings, and research on the effectiveness and possible uses of the tests.
• Advancing HIV Prevention: New Strategies for a Changing Epidemic
  In their new HIV prevention strategy, the CDC recommends routine HIV testing as part of regular medical care services.
• CDC Revised Guidelines for HIV Counseling, Testing, and Referral
  Read the CDC recommendations for public and private-sector policymakers and service providers of HIV counseling, testing, and referral (CTR). These revised guidelines differ from previous guidelines in several respects, including a new focus on the importance of early knowledge of HIV status and making testing more accessible.
• CDC Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care
  CDC's recommendations urge providers to include HIV testing as a routine part of their patients’ health-care. Routine HIV testing ensures more people learn whether they are infected with HIV, allowing them to benefit from earlier access to treatment, and reduce the risk of infecting their partners.