3. Promoting HIV Testing in Diverse Populations
Diagnosis in the ED
In several analyses, implementation of routine HIV screening programs has been shown to identify greater numbers of undiagnosed cases of HIV infection compared to standard risk-based screening procedures. Demonstration projects at 3 emergency departments evaluated the feasibility and acceptability of routinely offering rapid HIV testing in those facilities. [CDC Rapid] Across the 3 sites (in New York City, Los Angeles, and Oakland) as a whole, 56.5% of patients who were offered HIV testing accepted. For
all individuals testing positive with a rapid test, on-site confirmatory tests were performed. These procedures identified 97 patients as HIV-infected, and 88% of them were successfully linked to care. [CDC Rapid] The findings of this report suggest that offering routine HIV testing in emergency departments can identify individuals with previously undiagnosed HIV infection. At these sites, the investigators reported that risk-based HIV screening would have failed to test 48% of the persons whose HIV infections were newly diagnosed.
Following the CDC’s 2006 issuing of its revised recommendations for HIV testing, in 2010, the agency published updated data regarding more recent patterns of HIV testing in the United States. Earlier data had indicated that the percentage of Americans who had ever taken an HIV test remained at approximately 40% from 2001 to 2006.[Vital Signs 2010] Data from 2009, however, revealed that that number had increased to 45%. This 45% figure represents approximately 82.9 million adults, an increase of 11.4 million people who have ever been screen for HIV infection since 2006. Furthermore, a higher percentage of African Americans—approximately 60%—than any other racial group has been tested at least once during their lifetimes. This is encouraging in light of the disproportionately high rates of HIV infection among African Americans. [CDC Diagnoses 2011]
