HIV Testing and Screening in the Emergency Department

Approved by the ACEP Board of Directors April 2007  

Early diagnosis and treatment for human immunodeficiency virus (HIV) can prolong life, reduce transmission, and has been demonstrated to be a cost-effective public health intervention.

HIV testing in the evaluation for acute care conditions in the emergency department (ED) should be available in an expeditious and efficient fashion similar to testing and results for other conditions.

HIV screening when deemed appropriate by the emergency physician must meet the following conditions:

• Recommendations for HIV screening must be practical and feasible for emergency settings.
• Cannot interfere with the primary acute care mission of emergency medicine.
• Should be offered based on the local prevalence and medical needs of the community.
• Should be integrated with the resources of the entire health care system.
• Policies and procedures must adequately address patient confidentiality, informed consent (state dependent), provider training, significant need for pre and post-test counseling, and linkage to care.
• All local and state requirements must be met.
• Any such program must be contingent upon adequate funding to meet the added operational and personnel costs required for programs sustainability.